12D2120536 CLIA NUMBER - HAWAII DERMATOPATHOLOGY LLC

Laboratory Demographics

  • CLIA Code: 12D2120536
  • Facility Name: HAWAII DERMATOPATHOLOGY LLC
  • Facility Address: 1300 N HOLOPONO ST #214
    KIHEI, HI
    ZIP 96753
  • Facility Phone: 808 874-3446
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: AMY K. REISENAUER
  • NPI Number: 1780120709
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 12D2120536
LAB Type Physician Office
Facility Name HAWAII DERMATOPATHOLOGY LLC
Street 1300 N HOLOPONO ST #214
City KIHEI
State HI
ZIP 96753
Phone 808 874-3446
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/11/2024
Certificate Expiration Date 3/10/2026
Facility Type Physician Office
Lab Director AMY K. REISENAUER

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