12D0881550 CLIA NUMBER - KENNY R MALOTT MD INC

Laboratory Demographics

  • CLIA Code: 12D0881550
  • Facility Name: KENNY R MALOTT MD INC
  • Facility Address: 375 HUKU LII PLACE, STE 201
    KIHEI, HI
    ZIP 96753
  • Facility Phone: 808 875-7546
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. KENNY R. MALOTT
  • NPI Number: 1548202203
  • Taxonomy: 207NS0135X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 12D0881550
LAB Type Physician Office
Facility Name KENNY R MALOTT MD INC
Street 375 HUKU LII PLACE, STE 201
City KIHEI
State HI
ZIP 96753
Phone 808 875-7546
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Physician Office
Lab Director DR. KENNY R. MALOTT

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