14D2120644 CLIA NUMBER - FOREFRONT DERMATOLOGY S C

Laboratory Demographics

  • CLIA Code: 14D2120644
  • Facility Name: FOREFRONT DERMATOLOGY S C
  • Facility Address: 550 E BOUGHTON RD, STE 170
    BOLINGBROOK, IL
    ZIP 60440
  • Facility Phone: 630 739-3376
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BHARATI CHITTINENI MD
  • NPI Number: 1750837761
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 14D2120644
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY S C
Street 550 E BOUGHTON RD, STE 170
City BOLINGBROOK
State IL
ZIP 60440
Phone 630 739-3376
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Physician Office
Lab Director BHARATI CHITTINENI MD

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