10D2031258 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D2031258
  • Facility Name: MILLENNIUM PHYSICIAN GROUP LLC
  • Facility Address: 3000 S MCCALL RD
    ENGLEWOOD, FL
    ZIP 34224
  • Facility Phone: 941 460-6174
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAMON DELEON
  • NPI Number: 1538831300
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2031258
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP LLC
Street 3000 S MCCALL RD
City ENGLEWOOD
State FL
ZIP 34224
Phone 941 460-6174
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Physician Office
Lab Director RAMON DELEON

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