CLIA lab
CLIA 12D2229060: Kta Waikoloa Village Pharmacy
Waikoloa, HI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 12D2229060 belongs to Kta Waikoloa Village Pharmacy in Waikoloa, HI.
Certificate of Waiver, effective July 6, 2025, expires July 5, 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
- July 6, 2025
- Certificate expiration
- July 5, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 6, 2021
- Facility type
- Pharmacy
- 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
- 12D2229060
- Lab name
- Kta Waikoloa Village Pharmacy
- Address
- 68-3916 Paniolo Avenue, Waikoloa, HI 96738
- Phone
- (808) 883-8434
- Fax
- (808) 883-8540
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.
Related
Questions
What is the CLIA number for Kta Waikoloa Village Pharmacy in Waikoloa?
12D2229060, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Kta Waikoloa Village Pharmacy hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 12D2229060 expire?
The CMS file lists July 5, 2027 as the certificate expiration date; the certificate took effect July 6, 2025.