16D2020849 CLIA NUMBER - HY-VEE PHARMACY #1 - 1504

Laboratory Demographics

  • CLIA Code: 16D2020849
  • Facility Name: HY-VEE PHARMACY #1 - 1504
  • Facility Address: 1025 N QUINCY AVENUE
    OTTUMWA, IA
    ZIP 52501
  • Facility Phone: 641 683-4483
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH R. MILLER
  • NPI Number: 1558390898
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2020849
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #1 - 1504
Street 1025 N QUINCY AVENUE
City OTTUMWA
State IA
ZIP 52501
Phone 641 683-4483
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Pharmacy
Lab Director JOSEPH R. MILLER

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This page was last updated on: 3/20/2025