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INTEGRATED DERMATOLOGY OF FAIRFAX, LLC
NPI 1861890303
Dermatology in Fairfax, VA

Active since December 16, 2014CLIA 49D0221779 · Certificate of Compliance
10680 MAIN ST STE 200, FAIRFAX, VA 22030(703) 352-2620 Get Directions Write a Review

NPPES record last updated: February 21, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Integrated Dermatology Of Fairfax, Llc NPPES

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

INTEGRATED DERMATOLOGY OF FAIRFAX, LLC (NPI 1861890303) is a healthcare organization registered as a dermatology in Fairfax, Virginia and active in the NPI registry since December 2014. The organization holds a CLIA Certificate of Compliance certificate valid through February 27, 2027 and lists Jeffrey D. Queen, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1861890303
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINTEGRATED DERMATOLOGY OF FAIRFAX, LLC
Location Address10680 MAIN ST STE 200Fairfax, VA 22030-3810
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000
Phone(703) 352-2620
Organization SubpartNo
Authorized OfficialJeffrey D. QueenAuthorized Official · (561) 314-2000
Enumeration DateDecember 16, 2014
Last NPPES UpdateFebruary 21, 2024
NPPES CertifiedFebruary 21, 2024
✔ NPI 1861890303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
10680 MAIN ST STE 200, Fairfax, VA 22030
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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

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 Compliance 49D0221779

Integrated Dermatology Of Fairfax, LLC · Fairfax, VA
Active · expires Feb 27, 2027
CLIA Number49D0221779
Laboratory TypePhysician Office
Certificate Effective DateFebruary 28, 2025
Certificate Expiration DateFebruary 27, 2027
Laboratory DirectorRebecca T. Satoskar
Laboratory Phone(703) 352-2620
Laboratory LocationIntegrated Dermatology Of Fairfax, LLC10680 Main Street - Suite 200, Fairfax, VA 22030
CLIA data matches this NPI record on: Address 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 3

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

DR. AMANDA DERWAE M.D.
Dermatology
10680 MAIN ST STE 200
FAIRFAX, VA 22030
Fairfax City (703) 352-2620
REBECCA THERESA SATOSKAR MD
Dermatology
10680 MAIN ST STE 200
FAIRFAX, VA 22030
Fairfax City (703) 352-2620
DR. RAINA BEMBRY MD
Dermatology
10680 MAIN ST STE 200
FAIRFAX, VA 22030
Fairfax City (703) 352-2620

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 Integrated Dermatology Of Fairfax, LLC's NPI number?

The NPI number for Integrated Dermatology Of Fairfax, LLC is 1861890303. It was assigned to this organization in the NPPES registry on December 16, 2014.

Where is Integrated Dermatology Of Fairfax, LLC located?

Integrated Dermatology Of Fairfax, LLC is located at 10680 Main St Ste 200, Fairfax, VA 22030. The listed phone number is (703) 352-2620.

What is Integrated Dermatology Of Fairfax, LLC's specialty?

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

Does Integrated Dermatology Of Fairfax, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 49D0221779) is associated with this NPI, valid through February 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Integrated Dermatology Of Fairfax, LLC was last updated on February 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.