12D0889995 CLIA NUMBER - WCCHC-WAIPAHU FAMILY HELATH CENTER

Laboratory Demographics

  • CLIA Code: 12D0889995
  • Facility Name: WCCHC-WAIPAHU FAMILY HELATH CENTER
  • Facility Address: 94-428 MOKUOLA STREET #108B
    WAIPAHU, HI
    ZIP 96797
  • Facility Phone: 808 697-3888
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DR. STEPHEN BRADLEY
  • NPI Number: 1255608303
  • Taxonomy: 252Y00000X - Early Intervention Provider Agency

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CLIA Record

Field Name Field Value
CLIA Number 12D0889995
LAB Type Federally Qualified Health Center
Facility Name WCCHC-WAIPAHU FAMILY HELATH CENTER
Street 94-428 MOKUOLA STREET #108B
City WAIPAHU
State HI
ZIP 96797
Phone 808 697-3888
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Federally Qualified Health Center
Lab Director DR. STEPHEN BRADLEY

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