52D2058297 CLIA NUMBER - HY-VEE #1392

Laboratory Demographics

  • CLIA Code: 52D2058297
  • Facility Name: HY-VEE #1392
  • Facility Address: 675 S WHITNEY WAY
    MADISON, WI
    ZIP 53711
  • Facility Phone: 608 277-6735
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. PATRICK HARVEY
  • NPI Number: 1376885152
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2058297
LAB Type Pharmacy
Facility Name HY-VEE #1392
Street 675 S WHITNEY WAY
City MADISON
State WI
ZIP 53711
Phone 608 277-6735
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Pharmacy
Lab Director MR. PATRICK HARVEY

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