12D2163494 CLIA NUMBER - MAUI UROLOGY, LLC

Laboratory Demographics

  • CLIA Code: 12D2163494
  • Facility Name: MAUI UROLOGY, LLC
  • Facility Address: 1883 MILL ST, SUITE A
    WAILUKU, HI
    ZIP 96793
  • Facility Phone: 808 242-8765
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. SOREN N. CARLSEN
  • NPI Number: 1073179669
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 12D2163494
LAB Type Physician Office
Facility Name MAUI UROLOGY, LLC
Street 1883 MILL ST, SUITE A
City WAILUKU
State HI
ZIP 96793
Phone 808 242-8765
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Physician Office
Lab Director DR. SOREN N. CARLSEN

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