28D1081928 CLIA NUMBER - HY-VEE PHARMACY (1221)

Laboratory Demographics

  • CLIA Code: 28D1081928
  • Facility Name: HY-VEE PHARMACY (1221)
  • Facility Address: 115 WILMAR AVE
    GRAND ISLAND, NE
    ZIP 68803
  • Facility Phone: 308 381-0328
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW FOLCIK
  • NPI Number: 1770768947
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 28D1081928
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY (1221)
Street 115 WILMAR AVE
City GRAND ISLAND
State NE
ZIP 68803
Phone 308 381-0328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Pharmacy
Lab Director MATTHEW FOLCIK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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