41D2302939 CLIA NUMBER - BHG LXXIX, LLC D/B/A BHG MEDICAL SERVICES - RHODE ISLAND

Laboratory Demographics

  • CLIA Code: 41D2302939
  • Facility Name: BHG LXXIX, LLC D/B/A BHG MEDICAL SERVICES - RHODE ISLAND
  • Facility Address: 86 BEACH ST, OBOT ROOM #100
    WESTERLY, RI
    ZIP 02891
  • Facility Phone: (401) 596-0969
  • Facility Type: Other - OFFICE BASED OPIOID TREAT
  • Facility Type: Waiver
  • Lab Director: MEHGAN MAILLOUX
  • NPI Number: 1356055131
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 41D2302939
LAB Type Other - OFFICE BASED OPIOID TREAT
Facility Name BHG LXXIX, LLC D/B/A BHG MEDICAL SERVICES - RHODE ISLAND
Street 86 BEACH ST, OBOT ROOM #100
City WESTERLY
State RI
ZIP 02891
Phone 4015960969
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2026
Certificate Expiration Date 4/17/2028
Facility Type Other - OFFICE BASED OPIOID TREAT
Lab Director MEHGAN MAILLOUX

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This page was last updated on: 5/18/2026