18D2310865 CLIA NUMBER - BHG LVIII, LLC

Laboratory Demographics

  • CLIA Code: 18D2310865
  • Facility Name: BHG LVIII, LLC
  • Facility Address: 636 JEFFERSON AVENUE
    PAINTSVILLE, KY
    ZIP 41240
  • Facility Phone: 606 467-2627
  • Facility Type: Other - OFFICE BASED OPIOID TREAT
  • Facility Type: Waiver
  • Lab Director: MR. JACOB CAMPBELL
  • NPI Number: 1629600937
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2310865
LAB Type Other - OFFICE BASED OPIOID TREAT
Facility Name BHG LVIII, LLC
Street 636 JEFFERSON AVENUE
City PAINTSVILLE
State KY
ZIP 41240
Phone 606 467-2627
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2024
Certificate Expiration Date 9/11/2026
Facility Type Other - OFFICE BASED OPIOID TREAT
Lab Director MR. JACOB CAMPBELL

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