17D0972008 CLIA NUMBER - HY-VEE PHARMACY (1532)

Laboratory Demographics

  • CLIA Code: 17D0972008
  • Facility Name: HY-VEE PHARMACY (1532)
  • Facility Address: 7620 STATELINE
    PRAIRIE VILLAGE, KS
    ZIP 66208
  • Facility Phone: 913 383-8322
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PHIL WILLIAMS
  • NPI Number: 1225066384
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D0972008
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY (1532)
Street 7620 STATELINE
City PRAIRIE VILLAGE
State KS
ZIP 66208
Phone 913 383-8322
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Pharmacy
Lab Director PHIL WILLIAMS

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