14D2098692 CLIA NUMBER - HY-VEE #1520

Laboratory Demographics

  • CLIA Code: 14D2098692
  • Facility Name: HY-VEE #1520
  • Facility Address: 7610 N ORANGE PRAIRIE RD
    PEORIA, IL
    ZIP 61615
  • Facility Phone: 515 559-5708
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRAD MORIARTY
  • NPI Number: 1831573021
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2098692
LAB Type Pharmacy
Facility Name HY-VEE #1520
Street 7610 N ORANGE PRAIRIE RD
City PEORIA
State IL
ZIP 61615
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 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Pharmacy
Lab Director BRAD MORIARTY

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