28D1078303 CLIA NUMBER - HY-VEE PHARMACY #9 (1472)

Laboratory Demographics

  • CLIA Code: 28D1078303
  • Facility Name: HY-VEE PHARMACY #9 (1472)
  • Facility Address: 17810 WELCH PLAZA
    OMAHA, NE
    ZIP 68135
  • Facility Phone: 515 559-5708
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANE KLEIN
  • NPI Number: 1164467585
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D1078303
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY #9 (1472)
Street 17810 WELCH PLAZA
City OMAHA
State NE
ZIP 68135
Phone 515 559-5708
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Pharmacy
Lab Director SHANE KLEIN

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