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12D0619925 CLIA NUMBER - STEVE E CLARK, MD THELMA M YAMADA, MD

Laboratory Demographics

CLIA Number: 12D0619925

Facility Name: STEVE E CLARK, MD THELMA M YAMADA, MD

Facility Address:
1885 MAIN ST SUITE 405
WAILUKU, HI
ZIP 96793
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Facility Phone Number: 808 242-8526

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1255479424

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name Field Value
CLIA Number 12D0619925
LAB Type Physician Office
Facility Name STEVE E CLARK, MD THELMA M YAMADA, MD
Street 1885 MAIN ST SUITE 405
City WAILUKU
State HI
ZIP 96793
Phone 808 242-8526
CertificateType 4
CertificateEffectiveDate 5/3/2023
CertificateExpirationDate 5/2/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024