CLIA lab
CLIA 12D1105388: Ali'i Ambulatory Surgery Center
Kailua Kona, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D1105388 belongs to Ali'i Ambulatory Surgery Center in Kailua Kona, HI.
Certificate of Waiver, effective September 22, 2025, expires September 21, 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
- September 22, 2025
- Certificate expiration
- September 21, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 22, 2009
- Facility type
- Ambulatory surgery center
- Ownership (control type)
- Private
- Lab classification
- CLIA laboratory
- Directly affiliated labs
- 3
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 12D1105388
- Lab name
- Ali'i Ambulatory Surgery Center
- Address
- 75-5905 Walua Rd Suite 4, Kailua Kona, HI 96740
- Phone
- (808) 331-7960
- Fax
- (808) 331-0512
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Affiliated CLIA numbers
Other labs in Kailua Kona, HI
- Ali'i Health Center-ObgynCertificate of Waiver, Physician office12D1080403
- Ali'i Health Center-Primary CareCertificate of Waiver, Community clinic12D1078089
- Alii Health Center-PediatricsCertificate of Waiver, Community clinic12D0681330
- Allied Health Partners LLCCertificate of Waiver, Physician office12D2183374
- Beautiful You and AestheticsCertificate of Waiver, Physician office12D1037046
- DR David K Hiranaka MD DMDCertificate of Waiver, Physician office12D2181364
- Hawaii Dermatology & SurgeryCertificate of Registration, Physician office12D2335476
- Hawaii Health and Weight LossCertificate for Provider-Performed Microscopy Procedures, Physician office12D2145287
- Hawaii Island Community Health CenterCertificate of Waiver, Federally qualified health center12D0975941
- Hawaii Island RecoveryCertificate of Waiver, Other12D2145292
Related
Questions
What is the CLIA number for Ali'i Ambulatory Surgery Center in Kailua Kona?
12D1105388, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Ali'i Ambulatory Surgery Center hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 12D1105388 expire?
The CMS file lists September 21, 2027 as the certificate expiration date; the certificate took effect September 22, 2025.