16D2007492 CLIA NUMBER - HY-VEE PHARMACY #1058

Laboratory Demographics

  • CLIA Code: 16D2007492
  • Facility Name: HY-VEE PHARMACY #1058
  • Facility Address: 609 NORTH 18TH STREET
    CENTERVILLE, IA
    ZIP 52544
  • Facility Phone: 641 856-3832
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CANDACE OLIVER
  • NPI Number: 1871529537
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2007492
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #1058
Street 609 NORTH 18TH STREET
City CENTERVILLE
State IA
ZIP 52544
Phone 641 856-3832
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2024
Certificate Expiration Date 5/17/2026
Facility Type Pharmacy
Lab Director CANDACE OLIVER

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