12D2037088 CLIA NUMBER - HILO OBSTETRICS AND GYNECOLOGY LLC

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Laboratory Demographics

CLIA Number: 12D2037088

Facility Name: HILO OBSTETRICS AND GYNECOLOGY LLC

Facility Address:
82 PU'UHONU PL SUITE 211
HILO, HI
ZIP 96720
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Facility Phone Number: 808 933-2100

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1366710915

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	12D2037088
LAB Type	Physician Office
Facility Name	HILO OBSTETRICS AND GYNECOLOGY LLC
Street	82 PU'UHONU PL SUITE 211
City	HILO
State	HI
ZIP	96720
Phone	808 933-2100
CertificateType	3
CertificateEffectiveDate	2/17/2024
CertificateExpirationDate	2/16/2026
FacilityType	PPMP

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