28D2324545 CLIA NUMBER - HY-VEE PHARMACY (1227)

Laboratory Demographics

  • CLIA Code: 28D2324545
  • Facility Name: HY-VEE PHARMACY (1227)
  • Facility Address: 10855 S 191ST ST
    OMAHA, NE
    ZIP 68136
  • Facility Phone: 515 559-5708
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HAYLIN MAISENBACHER
  • NPI Number: 1700574324
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2324545
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY (1227)
Street 10855 S 191ST ST
City OMAHA
State NE
ZIP 68136
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 5/27/2025
Certificate Expiration Date 5/26/2027
Facility Type Pharmacy
Lab Director HAYLIN MAISENBACHER

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