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12D2058642 CLIA NUMBER - HAWAII VISION CLINIC, INC

Laboratory Demographics

CLIA Number: 12D2058642

Facility Name: HAWAII VISION CLINIC, INC

Facility Address:
99-128 AIEA HEIGHTS DR STE 703
AIEA, HI
ZIP 96701
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Facility Phone Number: 808 487-7938

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1912928367

Taxonomy: 305R00000X - Preferred Provider Organization
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.

CLIA Record

Field Name Field Value
CLIA Number 12D2058642
LAB Type Physician Office
Facility Name HAWAII VISION CLINIC, INC
Street 99-128 AIEA HEIGHTS DR STE 703
City AIEA
State HI
ZIP 96701
Phone 808 487-7938
CertificateType 4
CertificateEffectiveDate 5/9/2023
CertificateExpirationDate 5/8/2025
FacilityType Waiver

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