06D1031862 CLIA NUMBER - SAFEWAY PHARMACY #0876

Laboratory Demographics

  • CLIA Code: 06D1031862
  • Facility Name: SAFEWAY PHARMACY #0876
  • Facility Address: 731 S LEMAY AVE
    FORT COLLINS, CO
    ZIP 80524
  • Facility Phone: 970 490-1128
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SELENA GORDON
  • NPI Number: 1982642062
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D1031862
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0876
Street 731 S LEMAY AVE
City FORT COLLINS
State CO
ZIP 80524
Phone 970 490-1128
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Pharmacy
Lab Director SELENA GORDON

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