CLIA lab
CLIA 12D0974679: Maui Medical Group - Pukalani
Pukalani, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D0974679 belongs to Maui Medical Group - Pukalani in Pukalani, HI.
Certificate for Provider-Performed Microscopy Procedures, effective October 28, 2024, expires October 27, 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 for Provider-Performed Microscopy Procedures
- Certificate effective
- October 28, 2024
- Certificate expiration
- October 27, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 13, 2000
- Facility type
- Other
- 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
- 12D0974679
- Lab name
- Maui Medical Group - Pukalani
- Address
- 55 Pukalani St, Pukalani, HI 96768
- Phone
- (808) 573-6200
- Fax
- (808) 249-1902
Annual test volume the lab reported
- Waived tests
- 923
- Provider-performed microscopy tests
- 52
- Total
- 975
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Related
Questions
What is the CLIA number for Maui Medical Group - Pukalani in Pukalani?
12D0974679, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Maui Medical Group - Pukalani hold?
A Certificate for Provider-Performed Microscopy Procedures, according to the CMS file.
When does CLIA 12D0974679 expire?
The CMS file lists October 27, 2026 as the certificate expiration date; the certificate took effect October 28, 2024.