10D2157148 CLIA NUMBER - MILLENIUM CLINIC INC

Laboratory Demographics

  • CLIA Code: 10D2157148
  • Facility Name: MILLENIUM CLINIC INC
  • Facility Address: 1152 N UNIVERSITY DR #202
    PEMBROKE PINES, FL
    ZIP 33024
  • Facility Phone: 954 639-7345
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: FARID ASSOUAD
  • NPI Number: 1710303896
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 10D2157148
LAB Type Practitioner Other
Facility Name MILLENIUM CLINIC INC
Street 1152 N UNIVERSITY DR #202
City PEMBROKE PINES
State FL
ZIP 33024
Phone 954 639-7345
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Practitioner Other
Lab Director FARID ASSOUAD

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This page was last updated on: 6/4/2025