12D2021949 CLIA NUMBER - 15 CRAIGSIDE

Laboratory Demographics

  • CLIA Code: 12D2021949
  • Facility Name: 15 CRAIGSIDE
  • Facility Address: 15 CRAIGSIDE PLACE
    HONOLULU, HI
    ZIP 96817
  • Facility Phone: 808 523-7000
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROSALIE DSANSON
  • NPI Number: 1659658664
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 12D2021949
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name 15 CRAIGSIDE
Street 15 CRAIGSIDE PLACE
City HONOLULU
State HI
ZIP 96817
Phone 808 523-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ROSALIE DSANSON

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