06D2017579 CLIA NUMBER - CITY MARKET #434

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Laboratory Demographics

CLIA Number: 06D2017579

Facility Name: CITY MARKET #434

Facility Address:
0103 MARKET ST
EAGLE, CO
ZIP 81631
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Facility Phone Number: 970 328-1311

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1760428858

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	06D2017579
LAB Type	Pharmacy
Facility Name	CITY MARKET #434
Street	0103 MARKET ST
City	EAGLE
State	CO
ZIP	81631
Phone	970 328-1311
CertificateType	4
CertificateEffectiveDate	12/14/2022
CertificateExpirationDate	12/13/2024
FacilityType	Waiver

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