12D0999495 CLIA NUMBER - DEAN K OTAKA, MD

Laboratory Demographics

  • CLIA Code: 12D0999495
  • Facility Name: DEAN K OTAKA, MD
  • Facility Address: 98-1247 KAAHUMANU ST SUITE 115
    AIEA, HI
    ZIP 96701
  • Facility Phone: 808 486-5556
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEAN K. OTAKA
  • NPI Number: 1528079134
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 12D0999495
LAB Type Physician Office
Facility Name DEAN K OTAKA, MD
Street 98-1247 KAAHUMANU ST SUITE 115
City AIEA
State HI
ZIP 96701
Phone 808 486-5556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Physician Office
Lab Director DEAN K. OTAKA

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