19D2303792 CLIA NUMBER - BHG LXII, LLC BHG MEDICAL SERVICES LOUISIANA

Laboratory Demographics

  • CLIA Code: 19D2303792
  • Facility Name: BHG LXII, LLC BHG MEDICAL SERVICES LOUISIANA
  • Facility Address: 1910 RUFFIN DRIVE, OBOT ROOM 100
    MONROE, LA
    ZIP 71202
  • Facility Phone: 318 340-9596
  • Facility Type: Other - OFFICE BASED OPIOD
  • Facility Type: Waiver
  • Lab Director: ELLEN KING
  • NPI Number: 1871202598
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D2303792
LAB Type Other - OFFICE BASED OPIOD
Facility Name BHG LXII, LLC BHG MEDICAL SERVICES LOUISIANA
Street 1910 RUFFIN DRIVE, OBOT ROOM 100
City MONROE
State LA
ZIP 71202
Phone 318 340-9596
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Other - OFFICE BASED OPIOD
Lab Director ELLEN KING

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