15D2106510 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC

Laboratory Demographics

  • CLIA Code: 15D2106510
  • Facility Name: FOREFRONT DERMATOLOGY, SC
  • Facility Address: 954 N SAMUEL MOORE PKWY STE C
    MOORESVILLE, IN
    ZIP 46158
  • Facility Phone: 317 834-5466
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: AUGUST A. NATALIE
  • NPI Number: 1295107191
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 15D2106510
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC
Street 954 N SAMUEL MOORE PKWY STE C
City MOORESVILLE
State IN
ZIP 46158
Phone 317 834-5466
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 7/16/2025
Certificate Expiration Date 7/15/2027
Facility Type Physician Office
Lab Director AUGUST A. NATALIE

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