26D2107947 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC

Laboratory Demographics

  • CLIA Code: 26D2107947
  • Facility Name: FOREFRONT DERMATOLOGY, SC
  • Facility Address: 16516 MANCHESTER RD
    WILDWOOD, MO
    ZIP 63040
  • Facility Phone: 636 458-8400
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RACHEL M. QUALLEY
  • NPI Number: 1477927556
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 26D2107947
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC
Street 16516 MANCHESTER RD
City WILDWOOD
State MO
ZIP 63040
Phone 636 458-8400
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 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Physician Office
Lab Director RACHEL M. QUALLEY

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