12D0621051 CLIA NUMBER - CLIVE I OTSUKA MD

Laboratory Demographics

  • CLIA Code: 12D0621051
  • Facility Name: CLIVE I OTSUKA MD
  • Facility Address: 321 N KUAKINI 811
    HONOLULU, HI
    ZIP 96817
  • Facility Phone: 808 531-2731
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CLIVE I. OTSUKA
  • NPI Number: 1447256094
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 12D0621051
LAB Type Physician Office
Facility Name CLIVE I OTSUKA MD
Street 321 N KUAKINI 811
City HONOLULU
State HI
ZIP 96817
Phone 808 531-2731
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description 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.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director CLIVE I. OTSUKA

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