17D1077696 CLIA NUMBER - HYVEE PHARMACY #1422

Laboratory Demographics

  • CLIA Code: 17D1077696
  • Facility Name: HYVEE PHARMACY #1422
  • Facility Address: 6655 MARTWAY
    MISSION, KS
    ZIP 66202
  • Facility Phone: 913 831-4477
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAUREN ANDERSON
  • NPI Number: 1982649661
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D1077696
LAB Type Pharmacy
Facility Name HYVEE PHARMACY #1422
Street 6655 MARTWAY
City MISSION
State KS
ZIP 66202
Phone 913 831-4477
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2023
Certificate Expiration Date 12/16/2025
Facility Type Pharmacy
Lab Director LAUREN ANDERSON

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