10D1097857 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D1097857
  • Facility Name: MILLENNIUM PHYSICIAN GROUP LLC
  • Facility Address: 3440 TAMIAMI TR STE 2
    PORT CHARLOTTE, FL
    ZIP 33952
  • Facility Phone: 941 624-3600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEVEN CHRISTESEN
  • NPI Number: 1114680105
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1097857
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP LLC
Street 3440 TAMIAMI TR STE 2
City PORT CHARLOTTE
State FL
ZIP 33952
Phone 941 624-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Physician Office
Lab Director STEVEN CHRISTESEN

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This page was last updated on: 9/29/2025