24D2118079 CLIA NUMBER - HY-VEE #1165

Laboratory Demographics

CLIA Number: 24D2118079

Facility Name: HY-VEE #1165

Facility Address:
1500 CENTRAL PARK COMMONS DRIVE
EAGAN, MN
ZIP 55121
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Facility Phone Number: 651 405-3660

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1467908699

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	24D2118079
LAB Type	Pharmacy
Facility Name	HY-VEE #1165
Street	1500 CENTRAL PARK COMMONS DRIVE
City	EAGAN
State	MN
ZIP	55121
Phone	651 405-3660
CertificateType	4
CertificateEffectiveDate	8/30/2022
CertificateExpirationDate	8/29/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024