12D2196483 CLIA NUMBER - 5 MINUTE PHARMACY ALA MOANA LLC

Laboratory Demographics

  • CLIA Code: 12D2196483
  • Facility Name: 5 MINUTE PHARMACY ALA MOANA LLC
  • Facility Address: 725 KAPIOLANI BLVD SUITE C-111
    HONOLULU, HI
    ZIP 96813
  • Facility Phone: 808 797-2905
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEREK M. TENGAN
  • NPI Number: 1487047213
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 12D2196483
LAB Type Pharmacy
Facility Name 5 MINUTE PHARMACY ALA MOANA LLC
Street 725 KAPIOLANI BLVD SUITE C-111
City HONOLULU
State HI
ZIP 96813
Phone 808 797-2905
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

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