16D2209098 CLIA NUMBER - HY-VEE DRUGSTORE #7065

Laboratory Demographics

  • CLIA Code: 16D2209098
  • Facility Name: HY-VEE DRUGSTORE #7065
  • Facility Address: 1140 N JEFFERSON ST
    OTTUMWA, IA
    ZIP 52501
  • Facility Phone: 641 684-5467
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK A. HOGAN JR
  • NPI Number: 1356372700
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2209098
LAB Type Pharmacy
Facility Name HY-VEE DRUGSTORE #7065
Street 1140 N JEFFERSON ST
City OTTUMWA
State IA
ZIP 52501
Phone 641 684-5467
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2025
Certificate Expiration Date 1/10/2027
Facility Type Pharmacy
Lab Director MARK A. HOGAN JR

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