CLIA lab
CLIA 12D0724063: Pukalani Family Practice, LLC
Makawao, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D0724063 belongs to Pukalani Family Practice, LLC in Makawao, HI.
Certificate of Waiver, effective December 27, 2025, expires December 26, 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 Waiver
- Certificate effective
- December 27, 2025
- Certificate expiration
- December 26, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 24, 1993
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 12D0724063
- Lab name
- Pukalani Family Practice, LLC
- Address
- 81 Makawao Ave, Ste 100, Makawao, HI 96768
- Phone
- (808) 573-8900
- Fax
- (808) 572-3027
Annual test volume the lab reported
- Waived tests
- 1,320
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Hawaii Job Corps Center-MauiCertificate of Waiver, School or student health service12D0968053
- Pueo Family MedicineCertificate of Waiver, Physician office12D2269567
- Upcountry Urgent Care, LLCCertificate of Waiver, Other12D2350543
Related
Questions
What is the CLIA number for Pukalani Family Practice, LLC in Makawao?
12D0724063, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Pukalani Family Practice, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 12D0724063 expire?
The CMS file lists December 26, 2027 as the certificate expiration date; the certificate took effect December 27, 2025.