44D1088905 CLIA NUMBER - VCPHCS I, LLC DBA BHG MEMPHIS SOUTH TREATMENT CENTER

Laboratory Demographics

CLIA Number: 44D1088905

Facility Name: VCPHCS I, LLC DBA BHG MEMPHIS SOUTH TREATMENT CENTER

Facility Address:
4539 WINCHESTER ROAD, SUITE 111
MEMPHIS, TN
ZIP 38118
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Facility Phone Number: 901 375-1050

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1295994671

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D1088905
LAB Type	Other
Facility Name	VCPHCS I, LLC DBA BHG MEMPHIS SOUTH TREATMENT CENTER
Street	4539 WINCHESTER ROAD, SUITE 111
City	MEMPHIS
State	TN
ZIP	38118
Phone	901 375-1050
CertificateType	4
CertificateEffectiveDate	9/8/2022
CertificateExpirationDate	9/7/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024