12D1001774 CLIA NUMBER - KA'U HOSPITAL

Laboratory Demographics

CLIA Number: 12D1001774

Facility Name: KA'U HOSPITAL

Facility Address:
1 KAMANI STREET, BUILDING MAIN HOSPITAL
PAHALA, HI
ZIP 96777
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Facility Phone Number: 808 932-4390

Facility Type: Hospital

Certificate Type: Waiver

NPI Number: 1083209258

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	12D1001774
LAB Type	Hospital
Facility Name	KA'U HOSPITAL
Street	1 KAMANI STREET, BUILDING MAIN HOSPITAL
City	PAHALA
State	HI
ZIP	96777
Phone	808 932-4390
CertificateType	4
CertificateEffectiveDate	7/19/2022
CertificateExpirationDate	7/18/2024
FacilityType	Waiver

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