06D2070755 CLIA NUMBER - SAFEWAY PHARMACY #3729

Laboratory Demographics

  • CLIA Code: 06D2070755
  • Facility Name: SAFEWAY PHARMACY #3729
  • Facility Address: 1231 S PRAIRIE AVE
    PUEBLO, CO
    ZIP 81005
  • Facility Phone: 719 561-4407
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EVAN MAUGHAN
  • NPI Number: 1316983919
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2070755
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #3729
Street 1231 S PRAIRIE AVE
City PUEBLO
State CO
ZIP 81005
Phone 719 561-4407
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2024
Certificate Expiration Date 3/1/2026
Facility Type Pharmacy
Lab Director EVAN MAUGHAN

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