26D2306029 CLIA NUMBER - BHG LXXIV, LLC DBA BHG MEDICAL SERVICES-MISSOURI

Laboratory Demographics

  • CLIA Code: 26D2306029
  • Facility Name: BHG LXXIV, LLC DBA BHG MEDICAL SERVICES-MISSOURI
  • Facility Address: 404 EAST BATTLEFIELD STREE, OBOT ROOM #100
    SPRINGFIELD, MO
    ZIP 65807
  • Facility Phone: 417 865-8045
  • Facility Type: Other - OFFICE BASED OPIOD TREATM
  • Facility Type: Waiver
  • Lab Director: CHRISTINA MIKSELL
  • NPI Number: 1982315230
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2306029
LAB Type Other - OFFICE BASED OPIOD TREATM
Facility Name BHG LXXIV, LLC DBA BHG MEDICAL SERVICES-MISSOURI
Street 404 EAST BATTLEFIELD STREE, OBOT ROOM #100
City SPRINGFIELD
State MO
ZIP 65807
Phone 417 865-8045
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Other - OFFICE BASED OPIOD TREATM
Lab Director CHRISTINA MIKSELL

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