CLIA lab
CLIA 12D1073204: Pacific Endoscopy Center LLC
Pearl City, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D1073204 belongs to Pacific Endoscopy Center LLC in Pearl City, HI.
Certificate of Waiver, effective May 20, 2026, expires May 19, 2028.
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
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- May 20, 2026
- Certificate expiration
- May 19, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 4, 2007
- Facility type
- Ambulatory surgery center
- 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
- 12D1073204
- Lab name
- Pacific Endoscopy Center LLC
- Address
- 1029 Makolu St Suite H, Pearl City, HI 96782
- Phone
- (808) 456-6420
- Fax
- (615) 203-0338
Annual test volume the lab reported
- Waived tests
- 400
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Pearl City, HI
- Carlos B C Lam MDCertificate of Waiver, Physician office12D0692532
- Castle Physician NetworkCertificate of Waiver, Other12D2253716
- Hawaii State Doh-Hi State Laboratories DivisionCertificate of Compliance, Public health laboratory12D0646259
- Leeward Community College Health CenterCertificate of Waiver, School or student health service12D0970413
- Pearl City Nursing HomeCertificate of Waiver, Skilled nursing or nursing facility12D0914311
- Pearl City Specialized Residential Svcs ProgramCertificate of Waiver, Other12D1079401
- Plaza at Pearl City, LPCertificate of Waiver, Assisted living facility12D2194274
Related
Questions
What is the CLIA number for Pacific Endoscopy Center LLC in Pearl City?
12D1073204, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Pacific Endoscopy Center LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 12D1073204 expire?
The CMS file lists May 19, 2028 as the certificate expiration date; the certificate took effect May 20, 2026.