14D1077749 CLIA NUMBER - HY-VEE PHARMACY #1 (1215)

Laboratory Demographics

  • CLIA Code: 14D1077749
  • Facility Name: HY-VEE PHARMACY #1 (1215)
  • Facility Address: 1975 NATIONAL BLVD
    GALESBURG, IL
    ZIP 61401
  • Facility Phone: 515 559-5708
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ABBAS MEMON
  • NPI Number: 1851324602
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D1077749
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #1 (1215)
Street 1975 NATIONAL BLVD
City GALESBURG
State IL
ZIP 61401
Phone 515 559-5708
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2023
Certificate Expiration Date 12/17/2025
Facility Type Pharmacy
Lab Director ABBAS MEMON

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This page was last updated on: 9/29/2025