12D2098373 CLIA NUMBER - ISLAND UROLOGY OAHU LLC

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Laboratory Demographics

CLIA Number: 12D2098373

Facility Name: ISLAND UROLOGY OAHU LLC

Facility Address:
670 PONAHAWAI ST STE 217
HILO, HI
ZIP 96720
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Facility Phone Number: 808 536-2306

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1053592147

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

CLIA Record

Field Name	Field Value
CLIA Number	12D2098373
LAB Type	Physician Office
Facility Name	ISLAND UROLOGY OAHU LLC
Street	670 PONAHAWAI ST STE 217
City	HILO
State	HI
ZIP	96720
Phone	808 536-2306
CertificateType	4
CertificateEffectiveDate	7/6/2023
CertificateExpirationDate	7/5/2025
FacilityType	Waiver

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