24D2225802 CLIA NUMBER - HYVEE PHARMACY #1643

Laboratory Demographics

  • CLIA Code: 24D2225802
  • Facility Name: HYVEE PHARMACY #1643
  • Facility Address: 8155 HWY 65 NE
    SPRING LAKE PARK, MN
    ZIP 55432
  • Facility Phone: 763 792-8441
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HEATHER L. TERESIAK
  • NPI Number: 1720662182
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 24D2225802
LAB Type Pharmacy
Facility Name HYVEE PHARMACY #1643
Street 8155 HWY 65 NE
City SPRING LAKE PARK
State MN
ZIP 55432
Phone 763 792-8441
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director HEATHER L. TERESIAK

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