18D2307581 CLIA NUMBER - BHG LVIII, LLC

Laboratory Demographics

  • CLIA Code: 18D2307581
  • Facility Name: BHG LVIII, LLC
  • Facility Address: 455 PARK PLACE, SUITE 130, OBOT ROOM 100
    LEXINGTON, KY
    ZIP 40511
  • Facility Phone: 859 276-0533
  • Facility Type: Other - OFFICE BASED OPIOID TREAT
  • Facility Type: Waiver
  • Lab Director: MR. MATTHAN RIFFE
  • NPI Number: 1184256703
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2307581
LAB Type Other - OFFICE BASED OPIOID TREAT
Facility Name BHG LVIII, LLC
Street 455 PARK PLACE, SUITE 130, OBOT ROOM 100
City LEXINGTON
State KY
ZIP 40511
Phone 859 276-0533
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2024
Certificate Expiration Date 7/10/2026
Facility Type Other - OFFICE BASED OPIOID TREAT
Lab Director MR. MATTHAN RIFFE

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This page was last updated on: 3/20/2025