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KAUAI MEDICAL CLINIC
NPI 1871611558
Durable Medical Equipment & Medical Supplies in Koloa, HI

Active since March 27, 2007CLIA 12D0883256 · Waiver
KAUAI MEDICAL CLINIC - KOLOA CLINIC, 5371 KOLOA RD, KOLOA, HI 96756(808) 742-1621(808) 742-1592 Get Directions Write a Review

NPPES record last updated: April 27, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kauai Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAUAI MEDICAL CLINIC (NPI 1871611558) is a healthcare organization registered as a durable medical equipment & medical supplies in Koloa, Hawaii and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through December 9, 2026 and lists David Okabe, Cfo, Sr. Vice President, as its authorized official.

NPPES Registry Identity

NPI1871611558
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameKAUAI MEDICAL CLINIC
Location AddressKAUAI MEDICAL CLINIC - KOLOA CLINIC, 5371 KOLOA RDKoloa, HI 96756
Mailing Address1946 Young St, Suite 320Honolulu, HI 96826-2169 · (808) 973-7320 · Fax (808) 973-7325
Phone(808) 742-1621
Fax(808) 742-1592
Organization SubpartYes
Authorized OfficialDavid OkabeCfo, Sr. Vice President · (808) 535-7202
Enumeration DateMarch 27, 2007
Last NPPES UpdateApril 27, 2011
✔ NPI 1871611558 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
KAUAI MEDICAL CLINIC - KOLOA CLINIC, Koloa, HI 96756
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Other Identifiers 1

Medicare NSC1122930003HI

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 12D0883256

Kauai Medical Clinic - Koloa Clinic · Koloa, HI
Active · expires Dec 9, 2026
CLIA Number12D0883256
Laboratory TypeCommunity Clinic
Certificate Effective DateDecember 10, 2024
Certificate Expiration DateDecember 9, 2026
Laboratory DirectorTad Jackson
Laboratory Phone(808) 742-1621
Laboratory LocationKauai Medical Clinic - Koloa Clinic5371 Koloa Road, Koloa, HI 96756
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kauai Medical Clinic's NPI number?

The NPI number for Kauai Medical Clinic is 1871611558. It was assigned to this organization in the NPPES registry on March 27, 2007.

Where is Kauai Medical Clinic located?

Kauai Medical Clinic is located at Kauai Medical Clinic - Koloa Clinic 5371 Koloa Rd, Koloa, HI 96756. The listed phone number is (808) 742-1621.

What is Kauai Medical Clinic's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

Does Kauai Medical Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 12D0883256) is associated with this NPI, valid through December 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kauai Medical Clinic was last updated on April 27, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.