10D2241915 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D2241915
  • Facility Name: MILLENNIUM PHYSICIAN GROUP LLC
  • Facility Address: 120 MEDICAL DRIVE SUITE 103
    SPRING HILL, FL
    ZIP 34609
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELISA THOMPSON
  • NPI Number: 1396408654
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2241915
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP LLC
Street 120 MEDICAL DRIVE SUITE 103
City SPRING HILL
State FL
ZIP 34609
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 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Physician Office
Lab Director ELISA THOMPSON

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