10D2108518 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP, LLC

Laboratory Demographics

  • CLIA Code: 10D2108518
  • Facility Name: MILLENNIUM PHYSICIAN GROUP, LLC
  • Facility Address: 5741 BEE RIDGE RD - STE 250
    SARASOTA, FL
    ZIP 34233
  • Facility Phone: (941) 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GNANAMBAL MANIVEL
  • NPI Number: 1235801820
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2108518
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP, LLC
Street 5741 BEE RIDGE RD - STE 250
City SARASOTA
State FL
ZIP 34233
Phone 9417877665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2026
Certificate Expiration Date 2/7/2028
Facility Type Physician Office
Lab Director GNANAMBAL MANIVEL

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This page was last updated on: 5/18/2026