06D2075290 CLIA NUMBER - SAFEWAY PHARMACY #0722

Laboratory Demographics

  • CLIA Code: 06D2075290
  • Facility Name: SAFEWAY PHARMACY #0722
  • Facility Address: 457 W MAIN ST
    TRINIDAD, CO
    ZIP 81082
  • Facility Phone: (719) 846-3086
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HUONG PHAM
  • NPI Number: 1912936972
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2075290
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0722
Street 457 W MAIN ST
City TRINIDAD
State CO
ZIP 81082
Phone 7198463086
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2025
Certificate Expiration Date 11/3/2027
Facility Type Pharmacy
Lab Director HUONG PHAM

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This page was last updated on: 5/18/2026