12D0619218 CLIA NUMBER - PEDIATRIC CARE INC

Laboratory Demographics

  • CLIA Code: 12D0619218
  • Facility Name: PEDIATRIC CARE INC
  • Facility Address: 970 N KALAHEO AVE C103
    KAILUA, HI
    ZIP 96734
  • Facility Phone: 808 254-6474
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT E. ANDERSON
  • NPI Number: 1902980378
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 12D0619218
LAB Type Physician Office
Facility Name PEDIATRIC CARE INC
Street 970 N KALAHEO AVE C103
City KAILUA
State HI
ZIP 96734
Phone 808 254-6474
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2024
Certificate Expiration Date 5/9/2026
Facility Type Physician Office
Lab Director ROBERT E. ANDERSON

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