12D2016255 CLIA NUMBER - KAPA'A PEDIATRICS

Laboratory Demographics

  • CLIA Code: 12D2016255
  • Facility Name: KAPA'A PEDIATRICS
  • Facility Address: 4-1461 KUHIO HWY
    KAPAA, HI
    ZIP 96746
  • Facility Phone: 808 634-8011
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSE T. LAM
  • NPI Number: 1740586957
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 12D2016255
LAB Type Physician Office
Facility Name KAPA'A PEDIATRICS
Street 4-1461 KUHIO HWY
City KAPAA
State HI
ZIP 96746
Phone 808 634-8011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Physician Office
Lab Director JESSE T. LAM

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