12D1101501 CLIA NUMBER - MALAMA PONO HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 12D1101501
  • Facility Name: MALAMA PONO HEALTH SERVICES
  • Facility Address: 4370 KUKUI GROVE ST SUITE 3-115
    LIHUE, HI
    ZIP 96766
  • Facility Phone: 808 246-9577
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: DR. CAROL A. FUJIYOSHI
  • NPI Number: 1003274325
  • Taxonomy: 251K00000X - Public Health or Welfare

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CLIA Record

Field Name Field Value
CLIA Number 12D1101501
LAB Type Other
Facility Name MALAMA PONO HEALTH SERVICES
Street 4370 KUKUI GROVE ST SUITE 3-115
City LIHUE
State HI
ZIP 96766
Phone 808 246-9577
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2025
Certificate Expiration Date 6/25/2027
Facility Type Other
Lab Director DR. CAROL A. FUJIYOSHI

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