16D2209768 CLIA NUMBER - HY-VEE PHARMACY #3062

Laboratory Demographics

  • CLIA Code: 16D2209768
  • Facility Name: HY-VEE PHARMACY #3062
  • Facility Address: 621 5TH ST
    DURANT, IA
    ZIP 52747
  • Facility Phone: 515 559-5708
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TOM GANTENBELN
  • NPI Number: 1831669324
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2209768
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #3062
Street 621 5TH ST
City DURANT
State IA
ZIP 52747
Phone 515 559-5708
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Pharmacy
Lab Director TOM GANTENBELN

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