16D0688436 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC

Laboratory Demographics

  • CLIA Code: 16D0688436
  • Facility Name: FOREFRONT DERMATOLOGY, SC
  • Facility Address: 1005 PENNSYLVANIA AVENUE STE 210
    OTTUMWA, IA
    ZIP 52501
  • Facility Phone: 641 683-3195
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KENT D. WALKER
  • NPI Number: 1104274919
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 16D0688436
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC
Street 1005 PENNSYLVANIA AVENUE STE 210
City OTTUMWA
State IA
ZIP 52501
Phone 641 683-3195
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 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Physician Office
Lab Director KENT D. WALKER

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