12D2229839 CLIA NUMBER - KOA LABORATORY LLC DBA KOA LABS

Laboratory Demographics

  • CLIA Code: 12D2229839
  • Facility Name: KOA LABORATORY LLC DBA KOA LABS
  • Facility Address: 599 FARRINGTON HIGHWAY, BUILDING 2
    KAPOLEI, HI
    ZIP 96707
  • Facility Phone: 808 693-8807
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: ANDRE THERIAULT
  • NPI Number: 1316600588
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 12D2229839
LAB Type Independent
Facility Name KOA LABORATORY LLC DBA KOA LABS
Street 599 FARRINGTON HIGHWAY, BUILDING 2
City KAPOLEI
State HI
ZIP 96707
Phone 808 693-8807
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Independent
Lab Director ANDRE THERIAULT

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