24D2037651 CLIA NUMBER - HY-VEE PHARMACY 1183

Laboratory Demographics

  • CLIA Code: 24D2037651
  • Facility Name: HY-VEE PHARMACY 1183
  • Facility Address: 907 SOUTH STATE ST
    FAIRMONT, MN
    ZIP 56031
  • Facility Phone: 507 238-2880
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON SHULFER
  • NPI Number: 1285906628
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2037651
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY 1183
Street 907 SOUTH STATE ST
City FAIRMONT
State MN
ZIP 56031
Phone 507 238-2880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2025
Certificate Expiration Date 1/6/2027
Facility Type Pharmacy
Lab Director BRANDON SHULFER

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