12D0943004 CLIA NUMBER - PON-SANG CHAN, MD, INC

Laboratory Demographics

  • CLIA Code: 12D0943004
  • Facility Name: PON-SANG CHAN, MD, INC
  • Facility Address: 321 N KUAKINI ST SUITE 704
    HONOLULU, HI
    ZIP 96817
  • Facility Phone: 808 591-2118
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PON SANG CHAN
  • NPI Number: 1962463299
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 12D0943004
LAB Type Physician Office
Facility Name PON-SANG CHAN, MD, INC
Street 321 N KUAKINI ST SUITE 704
City HONOLULU
State HI
ZIP 96817
Phone 808 591-2118
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2024
Certificate Expiration Date 3/18/2026
Facility Type Physician Office
Lab Director DR. PON SANG CHAN

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