10D2248349 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP, LLC

Laboratory Demographics

  • CLIA Code: 10D2248349
  • Facility Name: MILLENNIUM PHYSICIAN GROUP, LLC
  • Facility Address: 9345 BEN C PRATT SIX MILE CYPRESS PKWY - STE 105
    FORT MYERS, FL
    ZIP 33966
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MANUEL GARCIA
  • NPI Number: 1225700065
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2248349
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP, LLC
Street 9345 BEN C PRATT SIX MILE CYPRESS PKWY - STE 105
City FORT MYERS
State FL
ZIP 33966
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 1/13/2024
Certificate Expiration Date 1/12/2026
Facility Type Physician Office
Lab Director MANUEL GARCIA

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