RENEWAL DERMATOLOGY PLLC
NPI 1619263407
Dermatology in Gainesville, VA

Active since June 21, 2011CLIA Certified · 2 labs
7512 GARDNER PARK DR, GAINESVILLE, VA 20155(703) 753-9860(703) 753-9863 Get Directions Write a Review

NPPES record last updated: June 21, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Renewal Dermatology Pllc NPPES

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

RENEWAL DERMATOLOGY PLLC (NPI 1619263407) is a healthcare organization registered as a dermatology in Gainesville, Virginia and active in the NPI registry since June 2011. The organization holds 2 active CLIA laboratory certificates and lists Joanne Gutliph, President, as its authorized official.

NPPES Registry Identity

NPI1619263407
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameRENEWAL DERMATOLOGY PLLC
Location Address7512 GARDNER PARK DRGainesville, VA 20155-3414
Mailing Address7512 Gardner Park DrGainesville, VA 20155-3414 · (703) 753-9860 · Fax (703) 753-9863
Fax(703) 753-9863
Organization SubpartNo
Authorized OfficialJoanne GutliphPresident · (571) 261-2885
Enumeration DateJune 21, 2011
NPI 1619263407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
7512 GARDNER PARK DR, Gainesville, VA 20155

Other Identifiers 1

Medicare PINC10787VA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 Accreditation 49D2034129

Renewal Dermatology And Medspa · Gainesville, VA
Active · expires Apr 22, 2028
CLIA Number49D2034129
Laboratory TypePhysician Office
Certificate Effective DateApril 23, 2026
Certificate Expiration DateApril 22, 2028
Laboratory DirectorDr. Kurt L. Maggio
Laboratory Phone(703) 753-9860
Laboratory LocationRenewal Dermatology And Medspa7512 Gardner Park Drive, Gainesville, VA 20155
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Compliance 49D2165185

Renewal Dermatology + Medspa · Springfield, VA
Active · expires Aug 20, 2027
CLIA Number49D2165185
Laboratory TypePhysician Office
Certificate Effective DateAugust 21, 2025
Certificate Expiration DateAugust 20, 2027
Laboratory DirectorKurt L. Maggio
Laboratory Phone(703) 753-9860
Laboratory LocationRenewal Dermatology + Medspa8136 Old Keene Mill Rd Ste A 201, Springfield, VA 22152
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 6

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

Dermatology
7512 GARDNER PARK DR
GAINESVILLE, VA 20155
Dermatology
7512 GARDNER PARK DR
GAINESVILLE, VA 20155
Physician Assistant
7512 GARDNER PARK DR
GAINESVILLE, VA 20155
Nurse Practitioner (Family)
7512 GARDNER PARK DR
GAINESVILLE, VA 20155
Dermatology (MOHS-Micrographic Surgery)
7512 GARDNER PARK DR
GAINESVILLE, VA 20155
Dermatology
7512 GARDNER PARK DR
GAINESVILLE, VA 20155

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 Renewal Dermatology PLLC's NPI number?

The NPI number for Renewal Dermatology PLLC is 1619263407. It was assigned to this organization in the NPPES registry on June 21, 2011.

Where is Renewal Dermatology PLLC located?

Renewal Dermatology PLLC is located at 7512 Gardner Park Dr, Gainesville, VA 20155. The listed phone number is (703) 753-9860.

What is Renewal Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Renewal Dermatology PLLC 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 Renewal Dermatology PLLC was last updated on June 21, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.