15D2119281 CLIA NUMBER - FOREFRONT DERMATOLOGY SC

Laboratory Demographics

  • CLIA Code: 15D2119281
  • Facility Name: FOREFRONT DERMATOLOGY SC
  • Facility Address: 2130 W SYCAMORE STREET, STE 200
    KOKOMO, IN
    ZIP 46901
  • Facility Phone: 765 457-4455
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: BAILEY E. TAYEBI
  • NPI Number: 1720477482
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 15D2119281
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY SC
Street 2130 W SYCAMORE STREET, STE 200
City KOKOMO
State IN
ZIP 46901
Phone 765 457-4455
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 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Physician Office
Lab Director BAILEY E. TAYEBI

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