18D2104302 CLIA NUMBER - FOREFRONT DERMATOLOGY SC DBA DERM SPECIALISTS

Laboratory Demographics

  • CLIA Code: 18D2104302
  • Facility Name: FOREFRONT DERMATOLOGY SC DBA DERM SPECIALISTS
  • Facility Address: 321 E BROADWAY ST STE 101
    CAMPBELLSVILLE, KY
    ZIP 42718
  • Facility Phone: 270 737-4503
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JEFFREY B. RICHARDSON
  • NPI Number: 1598135055
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 18D2104302
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY SC DBA DERM SPECIALISTS
Street 321 E BROADWAY ST STE 101
City CAMPBELLSVILLE
State KY
ZIP 42718
Phone 270 737-4503
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 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Physician Office
Lab Director DR. JEFFREY B. RICHARDSON

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