12D0877885 CLIA NUMBER - SAMUEL MAHELONA MEMORIAL HOSPITAL

Laboratory Demographics

CLIA Number: 12D0877885

Facility Name: SAMUEL MAHELONA MEMORIAL HOSPITAL

Facility Address:
4800 KAWAIHAU RD
KAPAA, HI
ZIP 96746
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Facility Phone Number: 808 822-4961

Facility Type: Hospital

Certificate Type: Certificate of Compliance

NPI Number: 1346419553

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	12D0877885
LAB Type	Hospital
Facility Name	SAMUEL MAHELONA MEMORIAL HOSPITAL
Street	4800 KAWAIHAU RD
City	KAPAA
State	HI
ZIP	96746
Phone	808 822-4961
CertificateType	2
CertificateEffectiveDate	3/10/2023
CertificateExpirationDate	3/9/2025
FacilityType	Compliance

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