12D2196477 CLIA NUMBER - 5 MINUTE PHARMACY LTC LLC

Laboratory Demographics

  • CLIA Code: 12D2196477
  • Facility Name: 5 MINUTE PHARMACY LTC LLC
  • Facility Address: 94-449 AKOKI ST, SUITE 102
    WAIPAHU, HI
    ZIP 96797
  • Facility Phone: 808 671-5511
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEREK M. TENGAN
  • NPI Number: 1104573088
  • Taxonomy: 3336S0011X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 12D2196477
LAB Type Pharmacy
Facility Name 5 MINUTE PHARMACY LTC LLC
Street 94-449 AKOKI ST, SUITE 102
City WAIPAHU
State HI
ZIP 96797
Phone 808 671-5511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2024
Certificate Expiration Date 10/15/2026
Facility Type Pharmacy
Lab Director DEREK M. TENGAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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