16D1017794 CLIA NUMBER - HY-VEE PHARMACY #4 - 1148

Laboratory Demographics

  • CLIA Code: 16D1017794
  • Facility Name: HY-VEE PHARMACY #4 - 1148
  • Facility Address: 4605 FLEUR DRIVE
    DES MOINES, IA
    ZIP 50321
  • Facility Phone: 515 285-7266
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAURA JOHNSON
  • NPI Number: 1053958348
  • Taxonomy: 3336M0002X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D1017794
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #4 - 1148
Street 4605 FLEUR DRIVE
City DES MOINES
State IA
ZIP 50321
Phone 515 285-7266
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2025
Certificate Expiration Date 10/5/2027
Facility Type Pharmacy
Lab Director LAURA JOHNSON

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