10D2250554 CLIA NUMBER - MILLENNIUM PHYSICIAN GROUP, LLC

Laboratory Demographics

  • CLIA Code: 10D2250554
  • Facility Name: MILLENNIUM PHYSICIAN GROUP, LLC
  • Facility Address: 7451 103RD ST STE 8
    JACKSONVILLE, FL
    ZIP 32210
  • Facility Phone: 941 787-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICK BUNYI
  • NPI Number: 1003588849
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2250554
LAB Type Physician Office
Facility Name MILLENNIUM PHYSICIAN GROUP, LLC
Street 7451 103RD ST STE 8
City JACKSONVILLE
State FL
ZIP 32210
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 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Physician Office
Lab Director PATRICK BUNYI

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