16D1077839 CLIA NUMBER - HY-VEE PHARMACY #1051

Laboratory Demographics

  • CLIA Code: 16D1077839
  • Facility Name: HY-VEE PHARMACY #1051
  • Facility Address: 905 US HIGHWAY 30 WEST
    CARROLL, IA
    ZIP 51401
  • Facility Phone: 712 792-9093
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTEN L. SAMPLE
  • NPI Number: 1558398453
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D1077839
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #1051
Street 905 US HIGHWAY 30 WEST
City CARROLL
State IA
ZIP 51401
Phone 712 792-9093
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Pharmacy
Lab Director KRISTEN L. SAMPLE

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