16D2008892 CLIA NUMBER - HY-VEE PHARMACY #2 - 1101

Laboratory Demographics

  • CLIA Code: 16D2008892
  • Facility Name: HY-VEE PHARMACY #2 - 1101
  • Facility Address: 1745 MADISON AVENUE
    COUNCIL BLUFFS, IA
    ZIP 51503
  • Facility Phone: 712 322-9222
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAURIE ANDERSON
  • NPI Number: 1336175975
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2008892
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #2 - 1101
Street 1745 MADISON AVENUE
City COUNCIL BLUFFS
State IA
ZIP 51503
Phone 712 322-9222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2024
Certificate Expiration Date 6/20/2026
Facility Type Pharmacy
Lab Director LAURIE ANDERSON

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