26D2305925 CLIA NUMBER - BHG LXXIV, LLC DBA BHG MEDICAL SERVICES-MISSOURI

Laboratory Demographics

  • CLIA Code: 26D2305925
  • Facility Name: BHG LXXIV, LLC DBA BHG MEDICAL SERVICES-MISSOURI
  • Facility Address: 1301 VANDIVER SQUARE, SUITE Y, OBOT ROOM #100
    COLUMBIA, MO
    ZIP 65202
  • Facility Phone: (573) 449-8338
  • Facility Type: Other - OFFICE BASED OPIOID TREAT
  • Facility Type: Waiver
  • Lab Director: LAURA CAMERON
  • NPI Number: 1255042594
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2305925
LAB Type Other - OFFICE BASED OPIOID TREAT
Facility Name BHG LXXIV, LLC DBA BHG MEDICAL SERVICES-MISSOURI
Street 1301 VANDIVER SQUARE, SUITE Y, OBOT ROOM #100
City COLUMBIA
State MO
ZIP 65202
Phone 5734498338
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2026
Certificate Expiration Date 6/6/2028
Facility Type Other - OFFICE BASED OPIOID TREAT
Lab Director LAURA CAMERON

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This page was last updated on: 6/29/2026