12D1079402 CLIA NUMBER - CARE COTTAGE HILO

Laboratory Demographics

  • CLIA Code: 12D1079402
  • Facility Name: CARE COTTAGE HILO
  • Facility Address: 100-A APOKE ST
    HILO, HI
    ZIP 96720
  • Facility Phone: 808 935-9411
  • Facility Type: Other - LICENSED CRISIS RES CTR
  • Facility Type: Waiver
  • Lab Director: JENNIFER SIATAFU
  • NPI Number: 1063757961
  • Taxonomy: 251B00000X - Case Management

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 12D1079402
LAB Type Other - LICENSED CRISIS RES CTR
Facility Name CARE COTTAGE HILO
Street 100-A APOKE ST
City HILO
State HI
ZIP 96720
Phone 808 935-9411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2024
Certificate Expiration Date 3/10/2026
Facility Type Other - LICENSED CRISIS RES CTR
Lab Director JENNIFER SIATAFU

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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