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16D1074092 CLIA NUMBER - HY-VEE PHARMACY #1872

Laboratory Demographics

CLIA Number: 16D1074092

Facility Name: HY-VEE PHARMACY #1872

Facility Address:
1311 4TH STREET SW
WAVERLY, IA
ZIP 50677
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Facility Phone Number: 515 559-5708

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1548296122

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 16D1074092
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #1872
Street 1311 4TH STREET SW
City WAVERLY
State IA
ZIP 50677
Phone 515 559-5708
CertificateType 4
CertificateEffectiveDate 9/24/2023
CertificateExpirationDate 9/23/2025
FacilityType Waiver

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