12D2087586 CLIA NUMBER - RAINBOW DIALYSIS LAHAINA

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Laboratory Demographics

CLIA Number: 12D2087586

Facility Name: RAINBOW DIALYSIS LAHAINA

Facility Address:
305 KEAWE ST SUITE 503
LAHAINA, HI
ZIP 96761
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Facility Phone Number: 808 661-8372

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1619381399

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	12D2087586
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	RAINBOW DIALYSIS LAHAINA
Street	305 KEAWE ST SUITE 503
City	LAHAINA
State	HI
ZIP	96761
Phone	808 661-8372
CertificateType	4
CertificateEffectiveDate	12/1/2022
CertificateExpirationDate	11/30/2024
FacilityType	Waiver

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