12D2170764 CLIA NUMBER - LANAI COMMUNITY DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 12D2170764
  • Facility Name: LANAI COMMUNITY DIALYSIS CENTER
  • Facility Address: 628 7TH STREET
    LANAI CITY, HI
    ZIP 96763
  • Facility Phone: 808 565-9650
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ADAM PROTAIN
  • NPI Number: 1962583328
  • Taxonomy: 282NC0060X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 12D2170764
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LANAI COMMUNITY DIALYSIS CENTER
Street 628 7TH STREET
City LANAI CITY
State HI
ZIP 96763
Phone 808 565-9650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ADAM PROTAIN

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