24D2113450 CLIA NUMBER - HY-VEE #1356

Laboratory Demographics

  • CLIA Code: 24D2113450
  • Facility Name: HY-VEE #1356
  • Facility Address: 16150 PILOT KNOB ROAD
    LAKEVILLE, MN
    ZIP 55044
  • Facility Phone: 952 423-9344
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WESLEY PEDERSON
  • NPI Number: 1851746986
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2113450
LAB Type Pharmacy
Facility Name HY-VEE #1356
Street 16150 PILOT KNOB ROAD
City LAKEVILLE
State MN
ZIP 55044
Phone 952 423-9344
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Pharmacy
Lab Director WESLEY PEDERSON

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