52D2058154 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC

Laboratory Demographics

  • CLIA Code: 52D2058154
  • Facility Name: FOREFRONT DERMATOLOGY, SC
  • Facility Address: 1656 DORSET LN STE 400
    NEW RICHMOND, WI
    ZIP 54017
  • Facility Phone: 715 246-4624
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MS. HOLLY REYNOLDS BUCHEN
  • NPI Number: 1124461843
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 52D2058154
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC
Street 1656 DORSET LN STE 400
City NEW RICHMOND
State WI
ZIP 54017
Phone 715 246-4624
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 4/30/2025
Certificate Expiration Date 4/29/2027
Facility Type Physician Office
Lab Director MS. HOLLY REYNOLDS BUCHEN

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