CLIA lab
CLIA 12D2125620: Five Mountains Hawaii Inc DBA Kipuka O Ke Ola
Kamuela, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D2125620 belongs to Five Mountains Hawaii Inc DBA Kipuka O Ke Ola in Kamuela, HI.
Certificate of Waiver, effective February 10, 2025, expires February 9, 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 10, 2025
- Certificate expiration
- February 9, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 10, 2017
- Facility type
- Rural health clinic
- Ownership (control type)
- Other
- 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
- 12D2125620
- Lab name
- Five Mountains Hawaii Inc DBA Kipuka O Ke Ola
- Address
- 64-1035 Mamalahoa Hwy Suite F, Kamuela, HI 96743
- Phone
- (808) 885-5900
- Fax
- (808) 885-6900
Annual test volume the lab reported
- Waived tests
- 1,600
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Kamuela, HI
- Diagnostic Laboratory Services-Queens Nhi HospCertificate of Accreditation, Independent12D2077899
- Diagnostic Laboratory Svcs-Qmc North Hi Path LabCertificate of Accreditation, Hospital12D2096714
- Kaiser Permanente Waimea Clinic PpmpCertificate for Provider-Performed Microscopy Procedures, Physician office12D0911714
- Kamuela Medical Associates IncCertificate of Waiver, Physician office12D0692936
- Kohala Coast Urgent CareCertificate for Provider-Performed Microscopy Procedures, Physician office12D2265189
- Kona Center of Facial SurgeryCertificate of Waiver, Other practitioner12D2198504
- Kta Kamuela PharmacyCertificate of Waiver, Pharmacy12D2237338
- Liberty Dialysis North Hawaii LLCCertificate of Waiver, End stage renal disease dialysis facility12D1086382
- Mango MedicalCertificate of Waiver, Other12D2302206
- Paniolo Pediatric and Family Medicine, IncCertificate of Waiver, Physician office12D2097582
Related
Questions
What is the CLIA number for Five Mountains Hawaii Inc DBA Kipuka O Ke Ola in Kamuela?
12D2125620, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Five Mountains Hawaii Inc DBA Kipuka O Ke Ola hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 12D2125620 expire?
The CMS file lists February 9, 2027 as the certificate expiration date; the certificate took effect February 10, 2025.