14D2076327 CLIA NUMBER - HY-VEE #1640

Laboratory Demographics

  • CLIA Code: 14D2076327
  • Facility Name: HY-VEE #1640
  • Facility Address: 2115 S MACARTHUR BLVD
    SPRINGFIELD, IL
    ZIP 62704
  • Facility Phone: 217 726-1001
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BERIT RABIN
  • NPI Number: 1891113973
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2076327
LAB Type Pharmacy
Facility Name HY-VEE #1640
Street 2115 S MACARTHUR BLVD
City SPRINGFIELD
State IL
ZIP 62704
Phone 217 726-1001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2024
Certificate Expiration Date 4/15/2026
Facility Type Pharmacy
Lab Director BERIT RABIN

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This page was last updated on: 6/4/2025