CLIA lab
CLIA 12D2170764: Lanai Community Dialysis Center
Lanai City, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D2170764 belongs to Lanai Community Dialysis Center in Lanai City, HI.
Certificate of Waiver, effective August 19, 2025, expires August 18, 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
- August 19, 2025
- Certificate expiration
- August 18, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 19, 2019
- Facility type
- End stage renal disease dialysis facility
- 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
- 12D2170764
- Lab name
- Lanai Community Dialysis Center
- Address
- 628 7th Street, Lanai City, HI 96763
- Phone
- (808) 565-9650
- Fax
- (808) 565-6357
Annual test volume the lab reported
- Waived tests
- 10
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Lanai City, HI
- Clinical Labs of Hawaii-Lanai Community HospitalCertificate of Compliance, Hospital12D0619602
- Lanai Community Health CenterCertificate of Waiver, Federally qualified health center12D1078523
- Lanai Community HospitalCertificate of Waiver, Skilled nursing or nursing facility12D2191304
- Lanai Kinaole IncCertificate of Waiver, Home health agency12D2197923
- Pol Straub Lanai Family Health CenterCertificate of Waiver, Community clinic12D0620105
Related
Questions
What is the CLIA number for Lanai Community Dialysis Center in Lanai City?
12D2170764, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Lanai Community Dialysis Center hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 12D2170764 expire?
The CMS file lists August 18, 2027 as the certificate expiration date; the certificate took effect August 19, 2025.