06D2017558 CLIA NUMBER - CITY MARKET #408

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Laboratory Demographics

CLIA Number: 06D2017558

Facility Name: CITY MARKET #408

Facility Address:
508 E MAIN
CORTEZ, CO
ZIP 81321
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Facility Phone Number: 970 565-6466

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1225064579

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	06D2017558
LAB Type	Pharmacy
Facility Name	CITY MARKET #408
Street	508 E MAIN
City	CORTEZ
State	CO
ZIP	81321
Phone	970 565-6466
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