19D2299411 CLIA NUMBER - BHG LXII, LLC BHG MEDICAL SERVICES - LOUISIANA

Laboratory Demographics

  • CLIA Code: 19D2299411
  • Facility Name: BHG LXII, LLC BHG MEDICAL SERVICES - LOUISIANA
  • Facility Address: 435 CORPORATE DRIVE, BUILDING #1, SUITE 103
    HOUMA, LA
    ZIP 70360
  • Facility Phone: 985 243-0062
  • Facility Type: Other - OFFICE BASED OPIOID TRX
  • Facility Type: Waiver
  • Lab Director: KRISTY ALEXANDER
  • NPI Number: 1487397030
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2299411
LAB Type Other - OFFICE BASED OPIOID TRX
Facility Name BHG LXII, LLC BHG MEDICAL SERVICES - LOUISIANA
Street 435 CORPORATE DRIVE, BUILDING #1, SUITE 103
City HOUMA
State LA
ZIP 70360
Phone 985 243-0062
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2024
Certificate Expiration Date 2/19/2026
Facility Type Other - OFFICE BASED OPIOID TRX
Lab Director KRISTY ALEXANDER

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This page was last updated on: 6/4/2025