06D2075310 CLIA NUMBER - SAFEWAY PHARMACY #1440

Laboratory Demographics

  • CLIA Code: 06D2075310
  • Facility Name: SAFEWAY PHARMACY #1440
  • Facility Address: 624 HWY 105
    MONUMENT, CO
    ZIP 80132
  • Facility Phone: 719 488-1189
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW L. MCDERMOTT
  • NPI Number: 1649209602
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 06D2075310
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1440
Street 624 HWY 105
City MONUMENT
State CO
ZIP 80132
Phone 719 488-1189
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2023
Certificate Expiration Date 11/9/2025
Facility Type Pharmacy
Lab Director MATTHEW L. MCDERMOTT

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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