10D2152036 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP, LLC

Laboratory Demographics

  • CLIA Code: 10D2152036
  • Facility Name: MILLENNIUM PHYSICIAN GROUP, LLC
  • Facility Address: 6311 SOUTH POINTE BLVD STE 300
    FORT MYERS, FL
    ZIP 33919
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MILENA LOUKANOVA
  • NPI Number: 1023684933
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2152036
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP, LLC
Street 6311 SOUTH POINTE BLVD STE 300
City FORT MYERS
State FL
ZIP 33919
Phone 941 787-7665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Physician Office
Lab Director MILENA LOUKANOVA

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