04D2180366 CLIA NUMBER - BHG L LLC BHG MEDICAL SERVICES- JONESBORO

Laboratory Demographics

  • CLIA Code: 04D2180366
  • Facility Name: BHG L LLC BHG MEDICAL SERVICES- JONESBORO
  • Facility Address: 5510 SOUTHWEST DRIVE, SUITE 8
    JONESBORO, AR
    ZIP 72404
  • Facility Phone: 870 520-6313
  • Facility Type: Other - OFFICE BASED OPIOID TREAT
  • Facility Type: Waiver
  • Lab Director: NICOLE PERALES
  • NPI Number: 1598398802
  • Taxonomy: 2084A0401X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 04D2180366
LAB Type Other - OFFICE BASED OPIOID TREAT
Facility Name BHG L LLC BHG MEDICAL SERVICES- JONESBORO
Street 5510 SOUTHWEST DRIVE, SUITE 8
City JONESBORO
State AR
ZIP 72404
Phone 870 520-6313
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2024
Certificate Expiration Date 3/11/2026
Facility Type Other - OFFICE BASED OPIOID TREAT
Lab Director NICOLE PERALES

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