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01D2162263 CLIA NUMBER - TENNESSEE RIVER DERMATOLOGY A FOREFRONT DERMATOLOGY PRACTICE

Laboratory Demographics

CLIA Number: 01D2162263

Facility Name: TENNESSEE RIVER DERMATOLOGY A FOREFRONT DERMATOLOGY PRACTICE

Facility Address:
220 FRENCH FARMS BLVD STE C
ATHENS, AL
ZIP 35611
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Facility Phone Number: 256 233-2000

Facility Type: Physician Office

Certificate Type: Certificate of Compliance
NPI Number: 1477568087

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 01D2162263
LAB Type Physician Office
Facility Name TENNESSEE RIVER DERMATOLOGY A FOREFRONT DERMATOLOGY PRACTICE
Street 220 FRENCH FARMS BLVD STE C
City ATHENS
State AL
ZIP 35611
Phone 256 233-2000
CertificateType 2
CertificateEffectiveDate 1/7/2024
CertificateExpirationDate 1/6/2026
FacilityType Compliance

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