12D2065941 CLIA NUMBER - MINIMALLY INVASIVE SURGERY OF HAWAII

Laboratory Demographics

  • CLIA Code: 12D2065941
  • Facility Name: MINIMALLY INVASIVE SURGERY OF HAWAII
  • Facility Address: 1401 S BERETANIA ST SUITE 600
    HONOLULU, HI
    ZIP 96814
  • Facility Phone: (808) 536-2261
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GARY BLUM
  • NPI Number: 1689013534
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 12D2065941
LAB Type Ambulatory Surgery Center
Facility Name MINIMALLY INVASIVE SURGERY OF HAWAII
Street 1401 S BERETANIA ST SUITE 600
City HONOLULU
State HI
ZIP 96814
Phone 8085362261
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2025
Certificate Expiration Date 9/16/2027
Facility Type Ambulatory Surgery Center
Lab Director GARY BLUM

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This page was last updated on: 5/18/2026