12D2164783 CLIA NUMBER - MASTERCARE, INC

Laboratory Demographics

  • CLIA Code: 12D2164783
  • Facility Name: MASTERCARE, INC
  • Facility Address: 1314 SOUTH KING SREET, SUITE 856
    HONOLULU, HI
    ZIP 96814
  • Facility Phone: 808 597-1564
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: NIKKI DOMSITZ
  • NPI Number: 1346872991
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 12D2164783
LAB Type Home Health Agency
Facility Name MASTERCARE, INC
Street 1314 SOUTH KING SREET, SUITE 856
City HONOLULU
State HI
ZIP 96814
Phone 808 597-1564
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Home Health Agency
Lab Director NIKKI DOMSITZ

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