CLIA lab
CLIA 12D0883256: Kauai Medical Clinic - Koloa Clinic
Koloa, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D0883256 belongs to Kauai Medical Clinic - Koloa Clinic in Koloa, HI.
Certificate of Waiver, effective December 10, 2024, expires December 9, 2026.
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 10, 2024
- Certificate expiration
- December 9, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 28, 1994
- Facility type
- Community clinic
- Ownership (control type)
- Private
- 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
- 12D0883256
- Lab name
- Kauai Medical Clinic - Koloa Clinic
- Address
- 5371 Koloa Road, Koloa, HI 96756
- Phone
- (808) 742-1621
- Fax
- (808) 742-1592
Annual test volume the lab reported
- Waived tests
- 456
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Koloa, HI
Related
Questions
What is the CLIA number for Kauai Medical Clinic - Koloa Clinic in Koloa?
12D0883256, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kauai Medical Clinic - Koloa Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 12D0883256 expire?
The CMS file lists December 9, 2026 as the certificate expiration date; the certificate took effect December 10, 2024.