27D2179886 CLIA NUMBER - FOREFRONT DERMATOLOGY, S C

Laboratory Demographics

  • CLIA Code: 27D2179886
  • Facility Name: FOREFRONT DERMATOLOGY, S C
  • Facility Address: 1821 SOUTH AVE W STE 402
    MISSOULA, MT
    ZIP 59801
  • Facility Phone: 406 543-8512
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEVIN R. MCMULLEN
  • NPI Number: 1922647395
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 27D2179886
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, S C
Street 1821 SOUTH AVE W STE 402
City MISSOULA
State MT
ZIP 59801
Phone 406 543-8512
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2024
Certificate Expiration Date 3/2/2026
Facility Type Physician Office
Lab Director KEVIN R. MCMULLEN

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