16D1077848 CLIA NUMBER - HY-VEE PHARMACY #5 - 1109

Laboratory Demographics

  • CLIA Code: 16D1077848
  • Facility Name: HY-VEE PHARMACY #5 - 1109
  • Facility Address: 2351 WEST LOCUST
    DAVENPORT, IA
    ZIP 52804
  • Facility Phone: 515 559-5708
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FATIMA SHAH
  • NPI Number: 1225064405
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D1077848
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #5 - 1109
Street 2351 WEST LOCUST
City DAVENPORT
State IA
ZIP 52804
Phone 515 559-5708
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 FATIMA SHAH

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