25D2273783 CLIA NUMBER - FOREFRONT DERMATOLOGY SC

Laboratory Demographics

  • CLIA Code: 25D2273783
  • Facility Name: FOREFRONT DERMATOLOGY SC
  • Facility Address: 113 W JACKSON ST STE 2C
    RIDGELAND, MS
    ZIP 39157
  • Facility Phone: 601 607-8222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. AMANDA M. DAGGETT
  • NPI Number: 1548996523
  • Taxonomy: 207N00000X - Dermatology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2273783
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY SC
Street 113 W JACKSON ST STE 2C
City RIDGELAND
State MS
ZIP 39157
Phone 601 607-8222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Physician Office
Lab Director DR. AMANDA M. DAGGETT

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