12D2229856 CLIA NUMBER - BRIDGE HOUSE

Laboratory Demographics

  • CLIA Code: 12D2229856
  • Facility Name: BRIDGE HOUSE
  • Facility Address: 78-6687B MAMALAHOA HIGHWAY
    HOLUALOA, HI
    ZIP 96725
  • Facility Phone: 808 322-3305
  • Facility Type: Other - SUBSTANCE ABUSE CONTINUUM
  • Facility Type: Waiver
  • Lab Director: ANDI PAWASARAT-LOSALIO
  • NPI Number: 1376878538
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 12D2229856
LAB Type Other - SUBSTANCE ABUSE CONTINUUM
Facility Name BRIDGE HOUSE
Street 78-6687B MAMALAHOA HIGHWAY
City HOLUALOA
State HI
ZIP 96725
Phone 808 322-3305
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2025
Certificate Expiration Date 7/15/2027
Facility Type Other - SUBSTANCE ABUSE CONTINUUM
Lab Director ANDI PAWASARAT-LOSALIO

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