12D2191496 CLIA NUMBER - ISLAND KIDNEY CARE

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Laboratory Demographics

CLIA Number: 12D2191496

Facility Name: ISLAND KIDNEY CARE

Facility Address:
105 MAUI LANI PARKWAY, SUITE 100
WAILUKU, HI
ZIP 96793
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Facility Phone Number: 808 442-7777

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1780228544

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	12D2191496
LAB Type	Physician Office
Facility Name	ISLAND KIDNEY CARE
Street	105 MAUI LANI PARKWAY, SUITE 100
City	WAILUKU
State	HI
ZIP	96793
Phone	808 442-7777
CertificateType	3
CertificateEffectiveDate	8/27/2022
CertificateExpirationDate	8/26/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024