12D0916363 CLIA NUMBER - HUI MALAMA OLA NA OIWI FAMILY MEDICINE CLINIC

Laboratory Demographics

CLIA Number: 12D0916363

Facility Name: HUI MALAMA OLA NA OIWI FAMILY MEDICINE CLINIC

Facility Address:
82 PU'UHONU PL, SUITE 209
HILO, HI
ZIP 96720
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Facility Phone Number: 808 796-3125

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1134133713

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	12D0916363
LAB Type	Community Clinic
Facility Name	HUI MALAMA OLA NA OIWI FAMILY MEDICINE CLINIC
Street	82 PU'UHONU PL, SUITE 209
City	HILO
State	HI
ZIP	96720
Phone	808 796-3125
CertificateType	3
CertificateEffectiveDate	7/22/2022
CertificateExpirationDate	7/21/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024