12D1043401 CLIA NUMBER - KONA CBOC

Laboratory Demographics

  • CLIA Code: 12D1043401
  • Facility Name: KONA CBOC
  • Facility Address: 75 5618 STREET SUITE 200
    KAILUA KONA, HI
    ZIP 96740
  • Facility Phone: 808 329-0774
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: MIN RO
  • NPI Number: 1033762760
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 12D1043401
LAB Type Community Clinic
Facility Name KONA CBOC
Street 75 5618 STREET SUITE 200
City KAILUA KONA
State HI
ZIP 96740
Phone 808 329-0774
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director MIN RO

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