10D2145178 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP

Laboratory Demographics

CLIA Number: 10D2145178

Facility Name: MILLENNIUM PHYSICIAN GROUP

Facility Address:
1659 US 27 NORTH
AVON PARK, FL
ZIP 33825
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Facility Phone Number: 941 764-1880

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1982377008

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D2145178
LAB Type	Physician Office
Facility Name	MILLENNIUM PHYSICIAN GROUP
Street	1659 US 27 NORTH
City	AVON PARK
State	FL
ZIP	33825
Phone	941 764-1880
CertificateType	4
CertificateEffectiveDate	3/2/2024
CertificateExpirationDate	3/1/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024