12D0911714 CLIA NUMBER - KAISER PERMANENTE WAIMEA CLINIC PPMP

Laboratory Demographics

  • CLIA Code: 12D0911714
  • Facility Name: KAISER PERMANENTE WAIMEA CLINIC PPMP
  • Facility Address: 67-1185 MAMALAHOA HIGHWAY
    KAMUELA, HI
    ZIP 96743
  • Facility Phone: 808 881-4560
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. GANDHI N. SACHIN
  • NPI Number: 1205390358
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 12D0911714
LAB Type Physician Office
Facility Name KAISER PERMANENTE WAIMEA CLINIC PPMP
Street 67-1185 MAMALAHOA HIGHWAY
City KAMUELA
State HI
ZIP 96743
Phone 808 881-4560
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 2/13/2024
Certificate Expiration Date 2/12/2026
Facility Type Physician Office
Lab Director DR. GANDHI N. SACHIN

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