10D2177690 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP

Laboratory Demographics

  • CLIA Code: 10D2177690
  • Facility Name: MILLENNIUM PHYSICIAN GROUP
  • Facility Address: 13691 METRO PKWY SUITE 420
    FORT MYERS, FL
    ZIP 33912
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BINH TRUONG
  • NPI Number: 1417324955
  • Taxonomy: 302R00000X - Health Maintenance Organization

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CLIA Record

Field Name Field Value
CLIA Number 10D2177690
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP
Street 13691 METRO PKWY SUITE 420
City FORT MYERS
State FL
ZIP 33912
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 BINH TRUONG

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