CLIA lab
CLIA 12D1065336: Kelly Medical Clinic
Ewa Beach, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D1065336 belongs to Kelly Medical Clinic in Ewa Beach, HI.
Certificate of Waiver, effective February 27, 2025, expires February 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
- February 27, 2025
- Certificate expiration
- February 26, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 27, 2007
- 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
- 12D1065336
- Lab name
- Kelly Medical Clinic
- Address
- 91-2139 Fort Weaver Rd #303, Ewa Beach, HI 96706
- Phone
- (808) 678-0700
- Fax
- (808) 678-0776
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- David Cha MDCertificate of Waiver, Physician office12D0928476
- Diagnostic Laboratory Svcs-Qmc West Oahu Path LabCertificate of Accreditation, Hospital12D2074321
- Elizabeth L Abinsay, MD, IncCertificate of Waiver, Physician office12D0935469
- Empower HealthCertificate of Waiver, Community clinic12D2180126
- Franklin Dao MDCertificate for Provider-Performed Microscopy Procedures, Physician office12D2097589
- Harry N Yoshino MDCertificate of Waiver, Physician office12D2097593
- Kulana MalamaCertificate of Waiver, Skilled nursing or nursing facility12D1065662
- Kurt D Yoshino MDCertificate for Provider-Performed Microscopy Procedures, Physician office12D2169929
- Liberty Dialysis-Hawaii Llc-Leeward DialysisCertificate of Waiver, End stage renal disease dialysis facility12D1051943
Related
Questions
What is the CLIA number for Kelly Medical Clinic in Ewa Beach?
12D1065336, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kelly Medical Clinic hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 12D1065336 expire?
The CMS file lists February 26, 2027 as the certificate expiration date; the certificate took effect February 27, 2025.