12D2032174 CLIA NUMBER - PACIFIC ASC LLC DBA EYE SURGERY CENTER OF HAWAII

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Laboratory Demographics

CLIA Number: 12D2032174

Facility Name: PACIFIC ASC LLC DBA EYE SURGERY CENTER OF HAWAII

Facility Address:
650 IWILEI RD SPACE 225
HONOLULU, HI
ZIP 96817
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Facility Phone Number: 808 356-4300

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1043502792

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	12D2032174
LAB Type	Ambulatory Surgery Center
Facility Name	PACIFIC ASC LLC DBA EYE SURGERY CENTER OF HAWAII
Street	650 IWILEI RD SPACE 225
City	HONOLULU
State	HI
ZIP	96817
Phone	808 356-4300
CertificateType	4
CertificateEffectiveDate	11/4/2023
CertificateExpirationDate	11/3/2025
FacilityType	Waiver

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