16D1008962 CLIA NUMBER - HY-VEE PHARMACY #3 - 1615

Laboratory Demographics

CLIA Number: 16D1008962

Facility Name: HY-VEE PHARMACY #3 - 1615

Facility Address:
3301 EAST GORDON DRIVE
SIOUX CITY, IA
ZIP 51105
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Facility Phone Number: 712 234-1949

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1316356827

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	16D1008962
LAB Type	Pharmacy
Facility Name	HY-VEE PHARMACY #3 - 1615
Street	3301 EAST GORDON DRIVE
City	SIOUX CITY
State	IA
ZIP	51105
Phone	712 234-1949
CertificateType	4
CertificateEffectiveDate	2/3/2023
CertificateExpirationDate	2/2/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024