24D2207524 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC DBA MINNEAPOLIS PLASTIC SURGERY, A FOREFRONT DERMATOLOGY PRACTICE

Laboratory Demographics

  • CLIA Code: 24D2207524
  • Facility Name: FOREFRONT DERMATOLOGY, SC DBA MINNEAPOLIS PLASTIC SURGERY, A FOREFRONT DERMATOLOGY PRACTICE
  • Facility Address: 4825 OLSON MEMORIAL HWY STE 200
    GOLDEN VALLEY, MN
    ZIP 55422
  • Facility Phone: 763 545-0443
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOUGLAS GERVAIS
  • NPI Number: 1528951035
  • Taxonomy: 208200000X - Plastic Surgery

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D2207524
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC DBA MINNEAPOLIS PLASTIC SURGERY, A FOREFRONT DERMATOLOGY PRACTICE
Street 4825 OLSON MEMORIAL HWY STE 200
City GOLDEN VALLEY
State MN
ZIP 55422
Phone 763 545-0443
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2025
Certificate Expiration Date 6/27/2027
Facility Type Physician Office
Lab Director DOUGLAS GERVAIS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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