12D2241343 CLIA NUMBER - WAIMEA PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 12D2241343
  • Facility Name: WAIMEA PRIMARY CARE, LLC
  • Facility Address: 65-1298 KAWAIHAE ROAD, SUITE 3
    KAMUELA, HI
    ZIP 96743
  • Facility Phone: (808) 731-5003
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARLY K. CORREA
  • NPI Number: 1417528399
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 12D2241343
LAB Type Physician Office
Facility Name WAIMEA PRIMARY CARE, LLC
Street 65-1298 KAWAIHAE ROAD, SUITE 3
City KAMUELA
State HI
ZIP 96743
Phone 8087315003
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2025
Certificate Expiration Date 10/26/2027
Facility Type Physician Office
Lab Director CARLY K. CORREA

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This page was last updated on: 5/18/2026