12D2041594 CLIA NUMBER - WHITE MOUNTAIN HEALTH LLC

Laboratory Demographics

  • CLIA Code: 12D2041594
  • Facility Name: WHITE MOUNTAIN HEALTH LLC
  • Facility Address: 65-1235 OPELO RD UNIT A STE 6
    KAMUELA, HI
    ZIP 96743
  • Facility Phone: 808 887-1210
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ROBERT B. HOLLANDER
  • NPI Number: 1366701708
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 12D2041594
LAB Type Physician Office
Facility Name WHITE MOUNTAIN HEALTH LLC
Street 65-1235 OPELO RD UNIT A STE 6
City KAMUELA
State HI
ZIP 96743
Phone 808 887-1210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Physician Office
Lab Director DR. ROBERT B. HOLLANDER

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