Koa Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

KOA LABORATORY LLC

Practice address

599 Farrington Hwy BLDG 2
Kapolei, HI 96707-2028

Phone

(808) 693-8807

Fax

(808) 674-4123

NPI assigned

Oct 14, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennalyn Bishop, MLS, TT

Title

Chief Medical Laboratory Scientist

Phone

(719) 505-5922

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Koa Labs Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in HI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634169600000",
    "number": "1316600588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "599 FARRINGTON HWY BLDG 2",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072028",
            "telephone_number": "808-693-8807",
            "fax_number": "808-674-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 FARRINGTON HWY BLDG 2",
            "city": "KAPOLEI",
            "state": "HI",
            "postal_code": "967072028",
            "telephone_number": "808-693-8807",
            "fax_number": "808-674-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOA LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "JENNALYN",
        "authorized_official_title_or_position": "CHIEF MEDICAL LABORATORY SCIENTIST",
        "authorized_official_telephone_number": "719-505-5922",
        "authorized_official_credential": "MLS, TT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "12D2229839",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.koalabshawaii.com",
            "affiliation": "N",
            "endpointDescription": "Client Portal",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "API",
            "address_1": "599 Farrington Hwy Bldg 2",
            "city": "Kapolei",
            "state": "HI",
            "country_code": "US",
            "postal_code": "967072028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Koa Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bree Kipilii
• David Kirsch, DMD
• Ai Kitanosono
• Angelyn Kitaura
• Angelina Knight
• Florentina K Kobuke
• Amanda Koch
• Kokua Psychological Services LLC
• Kokua Transport, LLC
• Carol L Komai, MPT

• Clinical Medical Laboratory in Kapolei, HI
• Providers in Kapolei, HI by specialty
• Clinical Medical Laboratory in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.