18D2305696 CLIA NUMBER - BHG LVIII, LLC

Laboratory Demographics

  • CLIA Code: 18D2305696
  • Facility Name: BHG LVIII, LLC
  • Facility Address: 1402 BROWNS LANE, SUITE A, OBOT ROOM #100
    LOUISVILLE, KY
    ZIP 40207
  • Facility Phone: 502 894-0234
  • Facility Type: Other - OFFICE BASED OPIOID TREAT
  • Facility Type: Waiver
  • Lab Director: MR. JUSTIN LINCEY
  • NPI Number: 1710727367
  • Taxonomy: 2084A0401X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 18D2305696
LAB Type Other - OFFICE BASED OPIOID TREAT
Facility Name BHG LVIII, LLC
Street 1402 BROWNS LANE, SUITE A, OBOT ROOM #100
City LOUISVILLE
State KY
ZIP 40207
Phone 502 894-0234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2024
Certificate Expiration Date 6/4/2026
Facility Type Other - OFFICE BASED OPIOID TREAT
Lab Director MR. JUSTIN LINCEY

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