12D2011663 CLIA NUMBER - KITAGAWA DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 12D2011663
  • Facility Name: KITAGAWA DERMATOLOGY LLC
  • Facility Address: 321 N KUAKINI ST STE 610
    HONOLULU, HI
    ZIP 96817
  • Facility Phone: 808 533-4434
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. KORY KITAGAWA
  • NPI Number: 1699095232
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 12D2011663
LAB Type Physician Office
Facility Name KITAGAWA DERMATOLOGY LLC
Street 321 N KUAKINI ST STE 610
City HONOLULU
State HI
ZIP 96817
Phone 808 533-4434
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Physician Office
Lab Director DR. KORY KITAGAWA

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