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24D2230156 CLIA NUMBER - HY-VEE PHARMACY #1440

Laboratory Demographics

CLIA Number: 24D2230156

Facility Name: HY-VEE PHARMACY #1440

Facility Address:
200 10TH AVE SE
NEW PRAGUE, MN
ZIP 56071
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Facility Phone Number: 952 758-2794

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1700456977

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 24D2230156
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #1440
Street 200 10TH AVE SE
City NEW PRAGUE
State MN
ZIP 56071
Phone 952 758-2794
CertificateType 4
CertificateEffectiveDate 7/20/2023
CertificateExpirationDate 7/19/2025
FacilityType Waiver

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