49D2152693 CLIA NUMBER - BHG XLII, LLC DBA BHG GLEN ALLEN TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 49D2152693
  • Facility Name: BHG XLII, LLC DBA BHG GLEN ALLEN TREATMENT CENTER
  • Facility Address: 13100 MOUNTAIN RD
    GLEN ALLEN, VA
    ZIP 23059
  • Facility Phone: 804 510-0556
  • Facility Type: Other - OUTPT OPIOID TREATMENT
  • Facility Type: Waiver
  • Lab Director: SHANNON PERKINSON
  • NPI Number: 1932696770
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2152693
LAB Type Other - OUTPT OPIOID TREATMENT
Facility Name BHG XLII, LLC DBA BHG GLEN ALLEN TREATMENT CENTER
Street 13100 MOUNTAIN RD
City GLEN ALLEN
State VA
ZIP 23059
Phone 804 510-0556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2024
Certificate Expiration Date 8/13/2026
Facility Type Other - OUTPT OPIOID TREATMENT
Lab Director SHANNON PERKINSON

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This page was last updated on: 6/4/2025