12D0621291 CLIA NUMBER - AVALON CARE CENTER HONOLULU LLC

Laboratory Demographics

  • CLIA Code: 12D0621291
  • Facility Name: AVALON CARE CENTER HONOLULU LLC
  • Facility Address: 1930 KAMEHAMEHA IV ROAD
    HONOLULU, HI
    ZIP 96819
  • Facility Phone: 808 847-4834
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BERNADETTE T. BEN
  • NPI Number: 1518951607
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 12D0621291
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AVALON CARE CENTER HONOLULU LLC
Street 1930 KAMEHAMEHA IV ROAD
City HONOLULU
State HI
ZIP 96819
Phone 808 847-4834
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2025
Certificate Expiration Date 7/7/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BERNADETTE T. BEN

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