24D2115287 CLIA NUMBER - HY-VEE #1040

Laboratory Demographics

  • CLIA Code: 24D2115287
  • Facility Name: HY-VEE #1040
  • Facility Address: 9409 ZANE AVE NORTH
    BROOKLYN PARK, MN
    ZIP 55443
  • Facility Phone: 763 488-4504
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WESTON TERESIAK
  • NPI Number: 1144679010
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2115287
LAB Type Pharmacy
Facility Name HY-VEE #1040
Street 9409 ZANE AVE NORTH
City BROOKLYN PARK
State MN
ZIP 55443
Phone 763 488-4504
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Pharmacy
Lab Director WESTON TERESIAK

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