10D2177689 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP

Laboratory Demographics

  • CLIA Code: 10D2177689
  • Facility Name: MILLENNIUM PHYSICIAN GROUP
  • Facility Address: 4130 TAMIAMI TRAIL SUITE 2
    PORT CHARLOTTE, FL
    ZIP 33952
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID L. MCATEE
  • NPI Number: 1700559341
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2177689
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP
Street 4130 TAMIAMI TRAIL SUITE 2
City PORT CHARLOTTE
State FL
ZIP 33952
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 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Physician Office
Lab Director DAVID L. MCATEE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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