12D0888590 CLIA NUMBER - FREDERICK NITTA, MD

Laboratory Demographics

  • CLIA Code: 12D0888590
  • Facility Name: FREDERICK NITTA, MD
  • Facility Address: 670 PONAHAWAI ST SUITE 200
    HILO, HI
    ZIP 96720
  • Facility Phone: 808 961-5922
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FREDERICK NITTA MD
  • NPI Number: 1023119385
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 12D0888590
LAB Type Physician Office
Facility Name FREDERICK NITTA, MD
Street 670 PONAHAWAI ST SUITE 200
City HILO
State HI
ZIP 96720
Phone 808 961-5922
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2024
Certificate Expiration Date 7/10/2026
Facility Type Physician Office
Lab Director FREDERICK NITTA MD

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