52D1041024 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC

Laboratory Demographics

  • CLIA Code: 52D1041024
  • Facility Name: FOREFRONT DERMATOLOGY, SC
  • Facility Address: 2806 RIVERVIEW DR
    GREEN BAY, WI
    ZIP 54313
  • Facility Phone: 920 498-7546
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. GINA P. SPOHN
  • NPI Number: 1760437644
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 52D1041024
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC
Street 2806 RIVERVIEW DR
City GREEN BAY
State WI
ZIP 54313
Phone 920 498-7546
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 10/4/2025
Certificate Expiration Date 10/3/2027
Facility Type Physician Office
Lab Director DR. GINA P. SPOHN

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