16D2012090 CLIA NUMBER - HY-VEE PHARMACY #1382

Laboratory Demographics

  • CLIA Code: 16D2012090
  • Facility Name: HY-VEE PHARMACY #1382
  • Facility Address: 1201 12TH AVENUE SW
    LE MARS, IA
    ZIP 51031
  • Facility Phone: 712 546-7816
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SERENA HANSEN
  • NPI Number: 1881620912
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2012090
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #1382
Street 1201 12TH AVENUE SW
City LE MARS
State IA
ZIP 51031
Phone 712 546-7816
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Pharmacy
Lab Director SERENA HANSEN

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