52D2271227 CLIA NUMBER - HY-VEE PHARMACY 1025

Laboratory Demographics

  • CLIA Code: 52D2271227
  • Facility Name: HY-VEE PHARMACY 1025
  • Facility Address: 2395 S ONEIDA ST, STE 100
    ASHWAUBENON, WI
    ZIP 54304
  • Facility Phone: (920) 305-7011
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY A. COBB
  • NPI Number: 1447975925
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 52D2271227
LAB Type Pharmacy
Facility Name HY-VEE PHARMACY 1025
Street 2395 S ONEIDA ST, STE 100
City ASHWAUBENON
State WI
ZIP 54304
Phone 9203057011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Pharmacy
Lab Director KELLY A. COBB

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This page was last updated on: 5/18/2026