12D0620170 CLIA NUMBER - FREDERICK FONG MD

Laboratory Demographics

  • CLIA Code: 12D0620170
  • Facility Name: FREDERICK FONG MD
  • Facility Address: 1380 LUSITANA ST, #514
    HONOLULU, HI
    ZIP 96813
  • Facility Phone: 808 531-7551
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FREDERICK FONG MD
  • NPI Number: 1588828727
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 12D0620170
LAB Type Physician Office
Facility Name FREDERICK FONG MD
Street 1380 LUSITANA ST, #514
City HONOLULU
State HI
ZIP 96813
Phone 808 531-7551
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2025
Certificate Expiration Date 8/10/2027
Facility Type Physician Office
Lab Director FREDERICK FONG MD

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