12D2099262 CLIA NUMBER - NOVA LUNA INC DBA AI PONO MAUI

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CLIA Record

Field Name Field Value
CLIA Number 12D2099262
LAB Type Other - RESIDENT TREATMENT CNTR
Facility Name NOVA LUNA INC DBA AI PONO MAUI
Street 470 LILIHUA PLACE
City WAILUKU
State HI
ZIP 96793
Phone 808 249-9999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Other - RESIDENT TREATMENT CNTR
Lab Director DR. BRIAN K. TELIHO

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