06D2074166 CLIA NUMBER - SAFEWAY PHARMACY #1615

Laboratory Demographics

  • CLIA Code: 06D2074166
  • Facility Name: SAFEWAY PHARMACY #1615
  • Facility Address: 3325 28TH ST
    BOULDER, CO
    ZIP 80301
  • Facility Phone: 303 938-9284
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELISSA BONOMO
  • NPI Number: 1710923339
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2074166
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1615
Street 3325 28TH ST
City BOULDER
State CO
ZIP 80301
Phone 303 938-9284
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Pharmacy
Lab Director MELISSA BONOMO

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