11D2300571 CLIA NUMBER - BHG LXVI, LLC DBA BHG MEDICAL SERVICES - GEORGIA

Laboratory Demographics

  • CLIA Code: 11D2300571
  • Facility Name: BHG LXVI, LLC DBA BHG MEDICAL SERVICES - GEORGIA
  • Facility Address: 794 MCDONOUGH ROAD, SUITE #104, OBOT ROOM #100
    JACKSON, GA
    ZIP 30233
  • Facility Phone: 770 775-9044
  • Facility Type: Other - OPIOID TREATMENT
  • Facility Type: Waiver
  • Lab Director: MONICA ROOKS
  • NPI Number: 1003510520
  • Taxonomy: 2084A0401X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 11D2300571
LAB Type Other - OPIOID TREATMENT
Facility Name BHG LXVI, LLC DBA BHG MEDICAL SERVICES - GEORGIA
Street 794 MCDONOUGH ROAD, SUITE #104, OBOT ROOM #100
City JACKSON
State GA
ZIP 30233
Phone 770 775-9044
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Other - OPIOID TREATMENT
Lab Director MONICA ROOKS

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