44D1088910 CLIA NUMBER - VCPHCS VIII, LLC DBA BHG MEMPHIS MIDTOWN TREATMENT CENTER

Laboratory Demographics

CLIA Number: 44D1088910

Facility Name: VCPHCS VIII, LLC DBA BHG MEMPHIS MIDTOWN TREATMENT CENTER

Facility Address:
1734 MADISON AVE
MEMPHIS, TN
ZIP 38104
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Facility Phone Number: 901 722-9420

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1477999480

Taxonomy: 261QR0405X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D1088910
LAB Type	Other
Facility Name	VCPHCS VIII, LLC DBA BHG MEMPHIS MIDTOWN TREATMENT CENTER
Street	1734 MADISON AVE
City	MEMPHIS
State	TN
ZIP	38104
Phone	901 722-9420
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