15D0681857 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC

Laboratory Demographics

  • CLIA Code: 15D0681857
  • Facility Name: FOREFRONT DERMATOLOGY, SC
  • Facility Address: 70 W 94TH PL
    CROWN POINT, IN
    ZIP 46307
  • Facility Phone: (219) 662-8822
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT P. DAZE
  • NPI Number: 1659796225
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 15D0681857
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC
Street 70 W 94TH PL
City CROWN POINT
State IN
ZIP 46307
Phone 2196628822
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2026
Certificate Expiration Date 12/31/2027
Facility Type Physician Office
Lab Director ROBERT P. DAZE

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This page was last updated on: 5/18/2026