12D0620086 CLIA NUMBER - HAWAII PACIFIC HEALTH MEDICAL GROUP AT HALE PAWA'A

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Laboratory Demographics

CLIA Number: 12D0620086

Facility Name: HAWAII PACIFIC HEALTH MEDICAL GROUP AT HALE PAWA'A

Facility Address:
1401 S BERETANIA ST SUITE 850
HONOLULU, HI
ZIP 96814
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Facility Phone Number: 808 373-7500

Facility Type: Other - CLINIC

Certificate Type: Microscopy

NPI Number: 1427365329

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	12D0620086
LAB Type	Other - CLINIC
Facility Name	HAWAII PACIFIC HEALTH MEDICAL GROUP AT HALE PAWA'A
Street	1401 S BERETANIA ST SUITE 850
City	HONOLULU
State	HI
ZIP	96814
Phone	808 373-7500
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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