12D0913686 CLIA NUMBER - KE OLA MAMO

Laboratory Demographics

  • CLIA Code: 12D0913686
  • Facility Name: KE OLA MAMO
  • Facility Address: 321 N KUAKINI ST STE 308 KUAKINI MEDICAL PLAZA
    HONOLULU, HI
    ZIP 96817
  • Facility Phone: 808 440-6852
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. NICOLE LUM
  • NPI Number: 1568655686
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 12D0913686
LAB Type Community Clinic
Facility Name KE OLA MAMO
Street 321 N KUAKINI ST STE 308 KUAKINI MEDICAL PLAZA
City HONOLULU
State HI
ZIP 96817
Phone 808 440-6852
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Community Clinic
Lab Director DR. NICOLE LUM

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