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

Laboratory Demographics

CLIA Number: 24D2154704

Facility Name: HY-VEE PHARMACY (1545)

Facility Address:
3505 BOTTINEAU BLVD
ROBBINSDALE, MN
ZIP 55422
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Facility Phone Number: 612 287-7204

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1922517499

Taxonomy: 314000000X - Skilled Nursing Facility
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

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
CertificateType	4
CertificateEffectiveDate	9/18/2022
CertificateExpirationDate	9/17/2024
FacilityType	Waiver

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