24D2154704 CLIA NUMBER - HY-VEE PHARMACY (1545)

Laboratory Demographics

  • CLIA Code: 24D2154704
  • Facility Name: HY-VEE PHARMACY (1545)
  • Facility Address: 3505 BOTTINEAU BLVD
    ROBBINSDALE, MN
    ZIP 55422
  • Facility Phone: 612 287-7204
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHOUA XIONG
  • NPI Number: 1922517499
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 24D2154704
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY (1545)
Street 3505 BOTTINEAU BLVD
City ROBBINSDALE
State MN
ZIP 55422
Phone 612 287-7204
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2024
Certificate Expiration Date 9/17/2026
Facility Type Pharmacy
Lab Director SHOUA XIONG

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