16D0994887 CLIA NUMBER - HY-VEE PHARMACY #1 - 1092

Laboratory Demographics

  • CLIA Code: 16D0994887
  • Facility Name: HY-VEE PHARMACY #1 - 1092
  • Facility Address: 2323 WEST BROADWAY
    COUNCIL BLUFFS, IA
    ZIP 51501
  • Facility Phone: 712 328-9792
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LESLIE NOTY
  • NPI Number: 1942239454
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D0994887
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #1 - 1092
Street 2323 WEST BROADWAY
City COUNCIL BLUFFS
State IA
ZIP 51501
Phone 712 328-9792
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Pharmacy
Lab Director LESLIE NOTY

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