12D2197607 CLIA NUMBER - LIHUE PHARMACY INC

Laboratory Demographics

  • CLIA Code: 12D2197607
  • Facility Name: LIHUE PHARMACY INC
  • Facility Address: 4491 KOLOPA ST #A
    LIHUE, HI
    ZIP 96766
  • Facility Phone: 808 246-9100
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRADLEY SIMMONS
  • NPI Number: 1356994834
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 12D2197607
LAB Type Pharmacy
Facility Name LIHUE PHARMACY INC
Street 4491 KOLOPA ST #A
City LIHUE
State HI
ZIP 96766
Phone 808 246-9100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Pharmacy
Lab Director BRADLEY SIMMONS

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