26D1075223 CLIA NUMBER - HY-VEE PHARMACY #1303

Laboratory Demographics

CLIA Number: 26D1075223

Facility Name: HY-VEE PHARMACY #1303

Facility Address:
3721 W TRUMAN BLVD
JEFFERSON CITY, MO
ZIP 65109
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Facility Phone Number: 573 634-2628

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1699968750

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	26D1075223
LAB Type	Pharmacy
Facility Name	HY-VEE PHARMACY #1303
Street	3721 W TRUMAN BLVD
City	JEFFERSON CITY
State	MO
ZIP	65109
Phone	573 634-2628
CertificateType	4
CertificateEffectiveDate	10/16/2023
CertificateExpirationDate	10/15/2025
FacilityType	Waiver

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