06D2017522 CLIA NUMBER - KING SOOPERS #89

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Laboratory Demographics

CLIA Number: 06D2017522

Facility Name: KING SOOPERS #89

Facility Address:
1150 HIGHWAY 287
BROOMFIELD, CO
ZIP 80020
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Facility Phone Number: 303 439-9040

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1205872397

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	06D2017522
LAB Type	Pharmacy
Facility Name	KING SOOPERS #89
Street	1150 HIGHWAY 287
City	BROOMFIELD
State	CO
ZIP	80020
Phone	303 439-9040
CertificateType	4
CertificateEffectiveDate	12/13/2022
CertificateExpirationDate	12/12/2024
FacilityType	Waiver

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