12D1063980 CLIA NUMBER - JAMES & ABIGAIL CAMPBELL CLINIC WAIANAE COAST COMP HEALTH CENTER NANAKULI

Laboratory Demographics

CLIA Number: 12D1063980

Facility Name: JAMES & ABIGAIL CAMPBELL CLINIC WAIANAE COAST COMP HEALTH CENTER NANAKULI

Facility Address:
89-102 FARRINGTON HWY
WAIANAE, HI
ZIP 96792
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Facility Phone Number: 808 697-3640

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1093880627

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	12D1063980
LAB Type	Community Clinic
Facility Name	JAMES & ABIGAIL CAMPBELL CLINIC WAIANAE COAST COMP HEALTH CENTER NANAKULI
Street	89-102 FARRINGTON HWY
City	WAIANAE
State	HI
ZIP	96792
Phone	808 697-3640
CertificateType	3
CertificateEffectiveDate	1/25/2023
CertificateExpirationDate	1/24/2025
FacilityType	PPMP

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