23D2131511 CLIA NUMBER - FOREFRONT DERMATOLOGY, S C

Laboratory Demographics

  • CLIA Code: 23D2131511
  • Facility Name: FOREFRONT DERMATOLOGY, S C
  • Facility Address: 1600 S BEACON BLVD SUITE 160
    GRAND HAVEN, MI
    ZIP 49417
  • Facility Phone: (616) 268-2001
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: NICHOLAS M. BONTUMASI
  • NPI Number: 1851822548
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 23D2131511
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, S C
Street 1600 S BEACON BLVD SUITE 160
City GRAND HAVEN
State MI
ZIP 49417
Phone 6162682001
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 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Physician Office
Lab Director NICHOLAS M. BONTUMASI

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