16D2001138 CLIA NUMBER - HY-VEE PHARMACY #1634

Laboratory Demographics

  • CLIA Code: 16D2001138
  • Facility Name: HY-VEE PHARMACY #1634
  • Facility Address: 1250 NORTH LAKE AVENUE
    STORM LAKE, IA
    ZIP 50588
  • Facility Phone: 712 732-1364
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SOPHIA J. JOHNSON
  • NPI Number: 1114963477
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2001138
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #1634
Street 1250 NORTH LAKE AVENUE
City STORM LAKE
State IA
ZIP 50588
Phone 712 732-1364
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Pharmacy
Lab Director SOPHIA J. JOHNSON

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