12D2236001 CLIA NUMBER - SOMA CLINIC

Laboratory Demographics

CLIA Number: 12D2236001

Facility Name: SOMA CLINIC

Facility Address:
2155 KALAKAUA AVENUE, SUITE 319
HONOLULU, HI
ZIP 96815
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Facility Phone Number: 808 722-4135

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1194415935

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	12D2236001
LAB Type	Physician Office
Facility Name	SOMA CLINIC
Street	2155 KALAKAUA AVENUE, SUITE 319
City	HONOLULU
State	HI
ZIP	96815
Phone	808 722-4135
CertificateType	4
CertificateEffectiveDate	9/14/2023
CertificateExpirationDate	9/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024