15D2264872 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC

Laboratory Demographics

  • CLIA Code: 15D2264872
  • Facility Name: FOREFRONT DERMATOLOGY, SC
  • Facility Address: 18051 RIVER RD STE 105
    NOBLESVILLE, IN
    ZIP 46062
  • Facility Phone: (317) 779-3956
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROBERT P. DAZE
  • NPI Number: 1588393607
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 15D2264872
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC
Street 18051 RIVER RD STE 105
City NOBLESVILLE
State IN
ZIP 46062
Phone 3177793956
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 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Physician Office
Lab Director ROBERT P. DAZE

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