11D2300582 CLIA NUMBER - BHG LXVI, LLC DBA BHG MEDICAL SERVICES - GEORGIA

Laboratory Demographics

  • CLIA Code: 11D2300582
  • Facility Name: BHG LXVI, LLC DBA BHG MEDICAL SERVICES - GEORGIA
  • Facility Address: 2402 TIFT AVENUE NORTH SUITE 201 & 202, OBOT ROOM 100
    TIFTON, GA
    ZIP 31794
  • Facility Phone: 229 382-7808
  • Facility Type: Other - OFFICE BASED OPIOID
  • Facility Type: Waiver
  • Lab Director: JAIME RYCROFT
  • NPI Number: 1043914591
  • Taxonomy: 2084A0401X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 11D2300582
LAB Type Other - OFFICE BASED OPIOID
Facility Name BHG LXVI, LLC DBA BHG MEDICAL SERVICES - GEORGIA
Street 2402 TIFT AVENUE NORTH SUITE 201 & 202, OBOT ROOM 100
City TIFTON
State GA
ZIP 31794
Phone 229 382-7808
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 - OFFICE BASED OPIOID
Lab Director JAIME RYCROFT

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