10D2219151 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP

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Laboratory Demographics

CLIA Number: 10D2219151

Facility Name: MILLENNIUM PHYSICIAN GROUP

Facility Address:
6037 WINTHROP COMMERCE AVENUE SUITE 201
RIVERVIEW, FL
ZIP 33578
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Facility Phone Number: 941 787-7665

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1538831128

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	10D2219151
LAB Type	Physician Office
Facility Name	MILLENNIUM PHYSICIAN GROUP
Street	6037 WINTHROP COMMERCE AVENUE SUITE 201
City	RIVERVIEW
State	FL
ZIP	33578
Phone	941 787-7665
CertificateType	4
CertificateEffectiveDate	4/2/2023
CertificateExpirationDate	4/1/2025
FacilityType	Waiver

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