18D2304065 CLIA NUMBER - BHG LVIII, LLC

Laboratory Demographics

  • CLIA Code: 18D2304065
  • Facility Name: BHG LVIII, LLC
  • Facility Address: 1990 LOUISVILLE ROAD, SUITE #110, OBOT ROOM #100
    BOWLING GREEN, KY
    ZIP 42101
  • Facility Phone: 270 782-2100
  • Facility Type: Other - OFFICE BASED OPIOID TREAT
  • Facility Type: Waiver
  • Lab Director: MS. CAYSEA COOPER
  • NPI Number: 1043050602
  • Taxonomy: 2084A0401X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 18D2304065
LAB Type Other - OFFICE BASED OPIOID TREAT
Facility Name BHG LVIII, LLC
Street 1990 LOUISVILLE ROAD, SUITE #110, OBOT ROOM #100
City BOWLING GREEN
State KY
ZIP 42101
Phone 270 782-2100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2024
Certificate Expiration Date 5/6/2026
Facility Type Other - OFFICE BASED OPIOID TREAT
Lab Director MS. CAYSEA COOPER

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