16D2210045 CLIA NUMBER - HY-VEE CLINIC PHARMACY #1504

Laboratory Demographics

  • CLIA Code: 16D2210045
  • Facility Name: HY-VEE CLINIC PHARMACY #1504
  • Facility Address: 301 W JEFFERSON STREET
    BLOOMFIELD, IA
    ZIP 52537
  • Facility Phone: 641 664-2975
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA B. MATHEWS
  • NPI Number: 1811939119
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2210045
LAB Type Pharmacy
Facility Name HY-VEE CLINIC PHARMACY #1504
Street 301 W JEFFERSON STREET
City BLOOMFIELD
State IA
ZIP 52537
Phone 641 664-2975
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2025
Certificate Expiration Date 1/18/2027
Facility Type Pharmacy
Lab Director AMANDA B. MATHEWS

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