52D2076925 CLIA NUMBER - FOREFRONT DERMATOLOGY, SC

Laboratory Demographics

  • CLIA Code: 52D2076925
  • Facility Name: FOREFRONT DERMATOLOGY, SC
  • Facility Address: 9020 76TH ST, SUITE E
    PLEASANT PRAIRIE, WI
    ZIP 53158
  • Facility Phone: 262 697-8030
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. SUSAN KEILER
  • NPI Number: 1578980165
  • Taxonomy: 207N00000X - Dermatology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2076925
LAB Type Physician Office
Facility Name FOREFRONT DERMATOLOGY, SC
Street 9020 76TH ST, SUITE E
City PLEASANT PRAIRIE
State WI
ZIP 53158
Phone 262 697-8030
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 6/20/2024
Certificate Expiration Date 6/19/2026
Facility Type Physician Office
Lab Director DR. SUSAN KEILER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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