26D2305921 CLIA NUMBER - BHG LXXIV, LLC DBA BHG MEDICAL SERVICES - MISSOURI

Laboratory Demographics

  • CLIA Code: 26D2305921
  • Facility Name: BHG LXXIV, LLC DBA BHG MEDICAL SERVICES - MISSOURI
  • Facility Address: 1639 BRUCE SMITH PARKWAY, OBOT ROOM #100
    WEST PLAINS, MO
    ZIP 65775
  • Facility Phone: 417 257-1833
  • Facility Type: Other - OFFICE BASED OPIOID TREAT
  • Facility Type: Waiver
  • Lab Director: TESS MILEY
  • NPI Number: 1710698055
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2305921
LAB Type Other - OFFICE BASED OPIOID TREAT
Facility Name BHG LXXIV, LLC DBA BHG MEDICAL SERVICES - MISSOURI
Street 1639 BRUCE SMITH PARKWAY, OBOT ROOM #100
City WEST PLAINS
State MO
ZIP 65775
Phone 417 257-1833
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 TESS MILEY

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