Provider Demographics
NPI:1104983733
Name:ANALYTIC LAB SYSTEMS INC
Entity type:Organization
Organization Name:ANALYTIC LAB SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:OYAMA
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:808-591-2844
Mailing Address - Street 1:1024 PIIKOI STREET
Mailing Address - Street 2:PIIKOI MEDICAL BUILDING
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1925
Mailing Address - Country:US
Mailing Address - Phone:808-591-2844
Mailing Address - Fax:808-591-2840
Practice Address - Street 1:1024 PIIKOI STREET
Practice Address - Street 2:PIIKOI MEDICAL BUILDING
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1925
Practice Address - Country:US
Practice Address - Phone:808-591-2844
Practice Address - Fax:808-591-2840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12D0620951291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI02395701Medicaid
HI00026641OtherBLUE CROSS BLUE SHIELD
X13208Medicare UPIN
HI02395701Medicaid