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16D1077862 CLIA NUMBER - HY-VEE MAINSTREET #7070

Laboratory Demographics

CLIA Number: 16D1077862

Facility Name: HY-VEE MAINSTREET #7070

Facility Address:
2611 PIERCE STREET
SIOUX CITY, IA
ZIP 51104
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Facility Phone Number: 712 258-0117

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1780629162

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 16D1077862
LAB Type Pharmacy
Facility Name HY-VEE MAINSTREET #7070
Street 2611 PIERCE STREET
City SIOUX CITY
State IA
ZIP 51104
Phone 712 258-0117
CertificateType 4
CertificateEffectiveDate 12/20/2023
CertificateExpirationDate 12/19/2025
FacilityType Waiver

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