26D2305869 CLIA NUMBER - BHG LXXIV, LLC D/B/A BHG MEDICAL SERVICES - MISSOURI

Laboratory Demographics

  • CLIA Code: 26D2305869
  • Facility Name: BHG LXXIV, LLC D/B/A BHG MEDICAL SERVICES - MISSOURI
  • Facility Address: 1369 NORTH WESTWOOD BLVD, STE C, OBOT ROOM 100
    POPLAR BLUFF, MO
    ZIP 63901
  • Facility Phone: 573 772-7937
  • Facility Type: Other - OFFICE BASED OPIOID TREAT
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER THOMASON
  • NPI Number: 1629789961
  • Taxonomy: 261QR0405X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 26D2305869
LAB Type Other - OFFICE BASED OPIOID TREAT
Facility Name BHG LXXIV, LLC D/B/A BHG MEDICAL SERVICES - MISSOURI
Street 1369 NORTH WESTWOOD BLVD, STE C, OBOT ROOM 100
City POPLAR BLUFF
State MO
ZIP 63901
Phone 573 772-7937
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2024
Certificate Expiration Date 6/6/2026
Facility Type Other - OFFICE BASED OPIOID TREAT
Lab Director CHRISTOPHER THOMASON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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