45D2063630 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC DBA COMPASSION DERMATOLOGY, A FOREFRONT DERMATOLOGY PRACTICE

Laboratory Demographics

  • CLIA Code: 45D2063630
  • Facility Name: FOREFRONT DERMATOLOGY, SC DBA COMPASSION DERMATOLOGY, A FOREFRONT DERMATOLOGY PRACTICE
  • Facility Address: 3065 W SOUTHLAKE BLVD, SUITE 140
    SOUTHLAKE, TX
    ZIP 76092
  • Facility Phone: 920 663-9008
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: HOLLY V. DEBUYS
  • NPI Number: 1942645387
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 45D2063630
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC DBA COMPASSION DERMATOLOGY, A FOREFRONT DERMATOLOGY PRACTICE
Street 3065 W SOUTHLAKE BLVD, SUITE 140
City SOUTHLAKE
State TX
ZIP 76092
Phone 920 663-9008
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 8/6/2025
Certificate Expiration Date 8/5/2027
Facility Type Physician Office
Lab Director HOLLY V. DEBUYS

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