14D0686707 CLIA NUMBER - PREMIER DERMATOLOGY FOREFRONT DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 14D0686707
  • Facility Name: PREMIER DERMATOLOGY FOREFRONT DERMATOLOGY
  • Facility Address: 2051 PLAINFIELD RD
    CREST HILL, IL
    ZIP 60403
  • Facility Phone: 920 663-9146
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: SOGYONG AUH
  • NPI Number: 1922053370
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D0686707
LAB Type Physician Office
Facility Name PREMIER DERMATOLOGY FOREFRONT DERMATOLOGY
Street 2051 PLAINFIELD RD
City CREST HILL
State IL
ZIP 60403
Phone 920 663-9146
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 5/20/2022
Certificate Expiration Date 9/30/2025
Facility Type Physician Office
Lab Director SOGYONG AUH

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