44D2223085 CLIA NUMBER - WELLNESS AMBULATORY CARE INC DBA BHG MED SERV JACKSON

Laboratory Demographics

  • CLIA Code: 44D2223085
  • Facility Name: WELLNESS AMBULATORY CARE INC DBA BHG MED SERV JACKSON
  • Facility Address: 58 CARRIAGE HOUSE, SUITE B, ROOM #101
    JACKSON, TN
    ZIP 38305
  • Facility Phone: 731 660-0880
  • Facility Type: Other - OPIOID TREATMENT OFFICE
  • Facility Type: Waiver
  • Lab Director: CHERYL BANAAG
  • NPI Number: 1902498538
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D2223085
LAB Type Other - OPIOID TREATMENT OFFICE
Facility Name WELLNESS AMBULATORY CARE INC DBA BHG MED SERV JACKSON
Street 58 CARRIAGE HOUSE, SUITE B, ROOM #101
City JACKSON
State TN
ZIP 38305
Phone 731 660-0880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Other - OPIOID TREATMENT OFFICE
Lab Director CHERYL BANAAG

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