10D2059794 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP

Laboratory Demographics

  • CLIA Code: 10D2059794
  • Facility Name: MILLENNIUM PHYSICIAN GROUP
  • Facility Address: 501 GOODLETTE RD N STE 100A
    NAPLES, FL
    ZIP 34102
  • Facility Phone: 941 764-1880
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CESAR DE LEON
  • NPI Number: 1245902030
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2059794
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP
Street 501 GOODLETTE RD N STE 100A
City NAPLES
State FL
ZIP 34102
Phone 941 764-1880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Physician Office
Lab Director CESAR DE LEON

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