CLIA lab
CLIA 12D2170840: Liberty Dialysis Hawaii LLC Mililani Dialysis
Mililani, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D2170840 belongs to Liberty Dialysis Hawaii LLC Mililani Dialysis in Mililani, HI.
Certificate of Waiver, effective August 20, 2025, expires August 19, 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 20, 2025
- Certificate expiration
- August 19, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 20, 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
- 12D2170840
- Lab name
- Liberty Dialysis Hawaii LLC Mililani Dialysis
- Address
- 95-1105 Ainamakua Drive, Suite 100, Mililani, HI 96789
- Phone
- (808) 626-6419
- Fax
- (808) 626-2354
Annual test volume the lab reported
- Waived tests
- 2,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Liberty Dialysis Hawaii MililaniCMS Care Compare ratings for the facility at the same street address
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- Complete Dermatology - MililaniCertificate of Compliance, Physician office12D2081591
- Grima Dermatology and Surgery, IncCertificate of Registration, Other12D2337130
- Queen's Health Care Centers-MililaniCertificate for Provider-Performed Microscopy Procedures, Community clinic12D2167390
- Straub Benioff Med CTR Mililani Clinic & Urg CareCertificate for Provider-Performed Microscopy Procedures, Community clinic12D2327720
- Ukuwai Properties, LLCCertificate of Waiver, Assisted living facility12D2193978
- WorkstarCertificate of Waiver, Physician office12D2328644
Related
Questions
What is the CLIA number for Liberty Dialysis Hawaii LLC Mililani Dialysis in Mililani?
12D2170840, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Liberty Dialysis Hawaii LLC Mililani Dialysis hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 12D2170840 expire?
The CMS file lists August 19, 2027 as the certificate expiration date; the certificate took effect August 20, 2025.