12D0953453 CLIA NUMBER - HHSC KAUAI REGION CLINICS CLINIC AT WAIMEA, THE

Laboratory Demographics

CLIA Number: 12D0953453

Facility Name: HHSC KAUAI REGION CLINICS CLINIC AT WAIMEA, THE

Facility Address:
4643 WAIMEA CANYON DRIVE STE B
WAIMEA, HI
ZIP 96796
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Facility Phone Number: 808 338-8311

Facility Type: Other - HAWAII HLTH SYS CORP

Certificate Type: Microscopy

NPI Number: 1669068680

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	12D0953453
LAB Type	Other - HAWAII HLTH SYS CORP
Facility Name	HHSC KAUAI REGION CLINICS CLINIC AT WAIMEA, THE
Street	4643 WAIMEA CANYON DRIVE STE B
City	WAIMEA
State	HI
ZIP	96796
Phone	808 338-8311
CertificateType	3
CertificateEffectiveDate	11/2/2022
CertificateExpirationDate	11/1/2024
FacilityType	PPMP

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