12D1031619 CLIA NUMBER - SIMON K CHANG MD, LLC

Laboratory Demographics

  • CLIA Code: 12D1031619
  • Facility Name: SIMON K CHANG MD, LLC
  • Facility Address: 1100 WARD AVENUE SUITE 701
    HONOLULU, HI
    ZIP 96814
  • Facility Phone: 808 599-2854
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SIMON K. CHANG
  • NPI Number: 1285635458
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 12D1031619
LAB Type Physician Office
Facility Name SIMON K CHANG MD, LLC
Street 1100 WARD AVENUE SUITE 701
City HONOLULU
State HI
ZIP 96814
Phone 808 599-2854
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Physician Office
Lab Director SIMON K. CHANG

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