16D2151594 CLIA NUMBER - EAGLE GROVE PHARMACY

Laboratory Demographics

  • CLIA Code: 16D2151594
  • Facility Name: EAGLE GROVE PHARMACY
  • Facility Address: 311 W BROADWAY
    EAGLE GROVE, IA
    ZIP 50533
  • Facility Phone: 515 448-3814
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW J. WAGNER
  • NPI Number: 1316968373
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2151594
LAB Type Pharmacy
Facility Name EAGLE GROVE PHARMACY
Street 311 W BROADWAY
City EAGLE GROVE
State IA
ZIP 50533
Phone 515 448-3814
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Pharmacy
Lab Director ANDREW J. WAGNER

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