14D2028668 CLIA NUMBER - HY-VEE STORE #1519

Laboratory Demographics

  • CLIA Code: 14D2028668
  • Facility Name: HY-VEE STORE #1519
  • Facility Address: 4125 N SHERIDAN RD, STE 20
    PEORIA, IL
    ZIP 61614
  • Facility Phone: 515 559-5708
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRAD MORIARTY
  • NPI Number: 1730490673
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2028668
LAB Type Pharmacy
Facility Name HY-VEE STORE #1519
Street 4125 N SHERIDAN RD, STE 20
City PEORIA
State IL
ZIP 61614
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 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Pharmacy
Lab Director BRAD MORIARTY

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