52D2073174 CLIA NUMBER - HY-VEE

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Laboratory Demographics

CLIA Number: 52D2073174

Facility Name: HY-VEE

Facility Address:
2920 FITCHRONA RD
FITCHBURG, WI
ZIP 53719
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Facility Phone Number: 608 273-5120

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1053732420

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	52D2073174
LAB Type	Pharmacy
Facility Name	HY-VEE
Street	2920 FITCHRONA RD
City	FITCHBURG
State	WI
ZIP	53719
Phone	608 273-5120
CertificateType	4
CertificateEffectiveDate	2/12/2024
CertificateExpirationDate	2/11/2026
FacilityType	Waiver

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