10D2239264 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D2239264
  • Facility Name: MILLENNIUM PHYSICIAN GROUP LLC
  • Facility Address: 10311 CROSS CREEK BLVD, SUITE B
    TAMPA, FL
    ZIP 33647
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NEKTARIOS DEMETRIOU
  • NPI Number: 1588336341
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2239264
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP LLC
Street 10311 CROSS CREEK BLVD, SUITE B
City TAMPA
State FL
ZIP 33647
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 7/11/2024
Certificate Expiration Date 7/10/2026
Facility Type Physician Office
Lab Director NEKTARIOS DEMETRIOU

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