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UNIVERSITY OF MARYLAND CHARLES REGIONAL OB/GYN
NPI 1205035805
Obstetrics & Gynecology in La Plata, MD

Active since July 13, 2007CLIA Certified · 2 labs
605 EAST CHARLES STREET, LA PLATA, MD 20646(301) 609-4800(301) 609-5220 Get Directions Write a Review

NPPES record last updated: May 15, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About University Of Maryland Charles Regional Ob/gyn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UNIVERSITY OF MARYLAND CHARLES REGIONAL OB/GYN (NPI 1205035805) is a healthcare organization registered as an obstetrics & gynecology in La Plata, Maryland and active in the NPI registry since July 2007. The organization holds 2 active CLIA laboratory certificates and lists Stephanie Simm, Physician Relations Specialists, as its authorized official.

NPPES Registry Identity

NPI1205035805
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NameCIVISTA CLINICAL SERVICES, LLC
Location Address605 EAST CHARLES STREETLa Plata, MD 20646
Mailing Address605 East Charles StreetLa Plata, MD 20646 · (301) 609-4800 · Fax (301) 609-5220
Phone(301) 609-4800
Fax(301) 609-5220
Organization SubpartYes
Authorized OfficialStephanie SimmPhysician Relations Specialists · (301) 609-4539
Enumeration DateJuly 13, 2007
Last NPPES UpdateMay 15, 2015
✔ NPI 1205035805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
605 EAST CHARLES STREET, La Plata, MD 20646
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Other Names 1

Doing Business AsUniversity Of Maryland Charles Regional Ob/gyn

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2342255

Civista Clinical Services LLC · La Plata, MD
Active · expires Apr 15, 2028
CLIA Number21D2342255
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateApril 16, 2026
Certificate Expiration DateApril 15, 2028
Laboratory DirectorDr. Vladimir Kakitelashvili
Laboratory Phone(301) 609-4894
Laboratory LocationCivista Clinical Services LLC101 Centennial Street #109 E, La Plata, MD 20646
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2230266

Civista Clinical Services LLC Dba Umcrmg Endoscopy · La Plata, MD
Active · expires Jul 20, 2027
CLIA Number21D2230266
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJuly 21, 2025
Certificate Expiration DateJuly 20, 2027
Laboratory DirectorJoseph Murphy
Laboratory Phone(301) 609-4510
Laboratory LocationCivista Clinical Services LLC Dba Umcrmg Endoscopy5 N La Plata Court Suite 201, La Plata, MD 20646
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ERICA CAMILLE CONTRERAS MD
Obstetrics & Gynecology
605 EAST CHARLES STREET
LA PLATA, MD 20646
Charles County (240) 427-1800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Civista Clinical Services, LLC's NPI number?

The NPI number for Civista Clinical Services, LLC is 1205035805. It was assigned to this organization in the NPPES registry on July 13, 2007. The provider is doing business as University Of Maryland Charles Regional Ob/Gyn.

Where is Civista Clinical Services, LLC located?

Civista Clinical Services, LLC is located at 605 East Charles Street, La Plata, MD 20646. The listed phone number is (301) 609-4800.

What is Civista Clinical Services, LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Does Civista Clinical Services, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Civista Clinical Services, LLC was last updated on May 15, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.