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CLINICAL DERMATOLOGY CENTER, LLC
NPI 1902428709
Dermatology in Chantilly, VA

Active since May 14, 2020CLIA Certified · 2 labs
14500 AVION PKWY STE 100, CHANTILLY, VA 20151(703) 705-7000(703) 763-7255 Get Directions Write a Review

NPPES record last updated: July 17, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 17, 2020, May 14, 2020 (2 updates tracked since 2020).

About Clinical Dermatology Center, Llc NPPES

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

CLINICAL DERMATOLOGY CENTER, LLC (NPI 1902428709) is a healthcare organization registered as a dermatology in Chantilly, Virginia and active in the NPI registry since May 2020. The organization holds 2 active CLIA laboratory certificates and lists Mikhail A Pavlov, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1902428709
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameCLINICAL DERMATOLOGY CENTER, LLC
Location Address14500 AVION PKWY STE 100Chantilly, VA 20151-1108
Mailing Address14500 Avion Pkwy Ste 100Chantilly, VA 20151-1108 · (703) 705-7000 · Fax (703) 763-7255
Phone(703) 705-7000
Fax(703) 763-7255
Organization SubpartNo
Authorized OfficialMikhail A PavlovPractice Manager · (410) 371-6302
Enumeration DateMay 14, 2020
Last NPPES UpdateJuly 17, 20202 updates tracked since enumeration
NPPES CertifiedJuly 17, 2020
✔ NPI 1902428709 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.
14500 AVION PKWY STE 100, Chantilly, VA 20151
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Other Identifiers 1

Other1578682894Individual Npi

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 Compliance 49D2198182

Clinical Dermatology Center - Chantilly · Chantilly, VA
Active · expires Mar 22, 2028
CLIA Number49D2198182
Laboratory TypePhysician Office
Certificate Effective DateMarch 23, 2026
Certificate Expiration DateMarch 22, 2028
Laboratory DirectorIlene B. Bayer-Garner
Laboratory Phone(703) 705-7000
Laboratory LocationClinical Dermatology Center - Chantilly14500 Avion Pkwy Suite 100, Chantilly, VA 20151
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.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D2320563

Clinical Dermatology Center, Arlington Office · Arlington, VA
Active · expires Mar 19, 2027
CLIA Number49D2320563
Laboratory TypePhysician Office
Certificate Effective DateMarch 20, 2025
Certificate Expiration DateMarch 19, 2027
Laboratory DirectorNickolai Y. Talanin
Laboratory Phone(703) 705-7000
Laboratory LocationClinical Dermatology Center, Arlington Office1235 S Clark St, Ste 205, Arlington, VA 22202
CLIA data matches this NPI record on: Name Phone
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.

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 Clinical Dermatology Center, LLC's NPI number?

The NPI number for Clinical Dermatology Center, LLC is 1902428709. It was assigned to this organization in the NPPES registry on May 14, 2020.

Where is Clinical Dermatology Center, LLC located?

Clinical Dermatology Center, LLC is located at 14500 Avion Pkwy Ste 100, Chantilly, VA 20151. The listed phone number is (703) 705-7000.

What is Clinical Dermatology Center, LLC's specialty?

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

Does Clinical Dermatology Center, 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 Clinical Dermatology Center, LLC was last updated on July 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.