12D1043404 CLIA NUMBER - HILO CBOC

Laboratory Demographics

  • CLIA Code: 12D1043404
  • Facility Name: HILO CBOC
  • Facility Address: 1285 WAIANUENUE AVE STE 211
    HILO, HI
    ZIP 96720
  • Facility Phone: 808 246-3781
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: MIN RO
  • NPI Number: 1225385347
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 12D1043404
LAB Type Community Clinic
Facility Name HILO CBOC
Street 1285 WAIANUENUE AVE STE 211
City HILO
State HI
ZIP 96720
Phone 808 246-3781
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 7/22/2005
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