CLIA lab
CLIA 12D0619633: Diagnostic Laboratory Services-Sam Mahelona Hosp
Kapaa, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D0619633 belongs to Diagnostic Laboratory Services-Sam Mahelona Hosp in Kapaa, HI.
Certificate of Compliance, effective May 1, 2025, expires April 30, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Compliance
- Certificate effective
- May 1, 2025
- Certificate expiration
- April 30, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- Facility type
- Independent
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 4
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 12D0619633
- Lab name
- Diagnostic Laboratory Services-Sam Mahelona Hosp
- Address
- 4800 Kawaihau Road, Outpatient Services Bldg-Dls, Kapaa, HI 96746
- Phone
- (808) 823-7184
- Fax
- (808) 698-6329
Annual test volume the lab reported
- Waived tests
- 5,154
- Provider-performed microscopy tests
- 3,654
- Other nonwaived tests
- 41,052
- Total
- 49,860
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Kapaa, HI
- Hhsc Kauai Region Clinics the Clinic at KapaaCertificate for Provider-Performed Microscopy Procedures, Rural health clinic12D2219386
- Ho'ola Lahui Hawaii Kauai Community Health CTRCertificate of Waiver, Community clinic12D1021610
- Kapa'a PediatricsCertificate of Waiver, Physician office12D2016255
- Kauai District Health Office Std/Aids Prev PrgmCertificate of Waiver, Community clinic12D2010107
- Kauai Home Care LLCCertificate of Waiver, Home health agency12D2349962
- Kauai Medical Clinic - Kapaa ClinicCertificate of Waiver, Community clinic12D0883258
- Olakino Family Practice, LLCCertificate of Waiver, Mobile lab12D2268616
- Samuel Mahelona Memorial HospitalCertificate of Compliance, Hospital12D0877885
- Wai Ola HealthCertificate of Waiver, Rural health clinic12D2342359
Related
Questions
What is the CLIA number for Diagnostic Laboratory Services-Sam Mahelona Hosp in Kapaa?
12D0619633, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Diagnostic Laboratory Services-Sam Mahelona Hosp hold?
A Certificate of Compliance, according to the CMS file.
When does CLIA 12D0619633 expire?
The CMS file lists April 30, 2027 as the certificate expiration date; the certificate took effect May 1, 2025.