12D2081587 CLIA NUMBER - COMPLETE DERMATOLOGY LLC KAPOLEI

Laboratory Demographics

  • CLIA Code: 12D2081587
  • Facility Name: COMPLETE DERMATOLOGY LLC KAPOLEI
  • Facility Address: 1001 KAMOKILA BLVD SUITE 181
    KAPOLEI, HI
    ZIP 96707
  • Facility Phone: 808 621-1000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. CHRISTOPHER LUM
  • NPI Number: 1467794842
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 12D2081587
LAB Type Physician Office
Facility Name COMPLETE DERMATOLOGY LLC KAPOLEI
Street 1001 KAMOKILA BLVD SUITE 181
City KAPOLEI
State HI
ZIP 96707
Phone 808 621-1000
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/12/2025
Certificate Expiration Date 7/11/2027
Facility Type Physician Office
Lab Director DR. CHRISTOPHER LUM

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