10D2020985 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP

Laboratory Demographics

  • CLIA Code: 10D2020985
  • Facility Name: MILLENNIUM PHYSICIAN GROUP
  • Facility Address: 60 WESTMINSTER ST STE A
    LEHIGH, FL
    ZIP 33936
  • Facility Phone: 239 368-1808
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RALPH M. TUCKER
  • NPI Number: 1326710070
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2020985
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP
Street 60 WESTMINSTER ST STE A
City LEHIGH
State FL
ZIP 33936
Phone 239 368-1808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Physician Office
Lab Director RALPH M. TUCKER

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