12D2026532 CLIA NUMBER - KA'U WELLNESS LLC

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Laboratory Demographics

CLIA Number: 12D2026532

Facility Name: KA'U WELLNESS LLC

Facility Address:
92-8691 LOTUS BLOSSOM LANE 6-7
OCEAN VIEW, HI
ZIP 96737
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Facility Phone Number: 808 939-8100

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1538611173

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	12D2026532
LAB Type	Physician Office
Facility Name	KA'U WELLNESS LLC
Street	92-8691 LOTUS BLOSSOM LANE 6-7
City	OCEAN VIEW
State	HI
ZIP	96737
Phone	808 939-8100
CertificateType	3
CertificateEffectiveDate	10/18/2023
CertificateExpirationDate	10/17/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024