16D1077850 CLIA NUMBER - HY-VEE PHARMACY #1202

Laboratory Demographics

  • CLIA Code: 16D1077850
  • Facility Name: HY-VEE PHARMACY #1202
  • Facility Address: 2606 AVENUE L
    FORT MADISON, IA
    ZIP 52627
  • Facility Phone: 319 372-9396
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. ODAY-DOSTALEK
  • NPI Number: 1912933565
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D1077850
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #1202
Street 2606 AVENUE L
City FORT MADISON
State IA
ZIP 52627
Phone 319 372-9396
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 JENNIFER L. ODAY-DOSTALEK

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