12D1072255 CLIA NUMBER - HONOLULU SPINE CENTER LLC

Laboratory Demographics

  • CLIA Code: 12D1072255
  • Facility Name: HONOLULU SPINE CENTER LLC
  • Facility Address: 500 ALA MOANA BLVD BLDG 1 STE 301
    HONOLULU, HI
    ZIP 96813
  • Facility Phone: 808 237-2970
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. JEFFREY ROH
  • NPI Number: 1093830325
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 12D1072255
LAB Type Ambulatory Surgery Center
Facility Name HONOLULU SPINE CENTER LLC
Street 500 ALA MOANA BLVD BLDG 1 STE 301
City HONOLULU
State HI
ZIP 96813
Phone 808 237-2970
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. JEFFREY ROH

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