26D1026937 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC

Laboratory Demographics

  • CLIA Code: 26D1026937
  • Facility Name: FOREFRONT DERMATOLOGY, SC
  • Facility Address: 9209 PHOENIX VILLAGE PARKWAY
    O FALLON, MO
    ZIP 63368
  • Facility Phone: 636 561-4613
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROBYN FANDERCLAI
  • NPI Number: 1689039836
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 26D1026937
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC
Street 9209 PHOENIX VILLAGE PARKWAY
City O FALLON
State MO
ZIP 63368
Phone 636 561-4613
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 1/22/2024
Certificate Expiration Date 1/21/2026
Facility Type Physician Office
Lab Director ROBYN FANDERCLAI

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