12D0693619 CLIA NUMBER - MARK CHUNG MD

Laboratory Demographics

CLIA Number: 12D0693619

Facility Name: MARK CHUNG MD

Facility Address:
40 AULIKE ST SUITE 412
KAILUA, HI
ZIP 96734
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Facility Phone Number: 808 263-4882

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609832435

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	12D0693619
LAB Type	Physician Office
Facility Name	MARK CHUNG MD
Street	40 AULIKE ST SUITE 412
City	KAILUA
State	HI
ZIP	96734
Phone	808 263-4882
CertificateType	4
CertificateEffectiveDate	9/20/2022
CertificateExpirationDate	9/19/2024
FacilityType	Waiver

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