06D2075332 CLIA NUMBER - SAFEWAY PHARMACY #1116

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Laboratory Demographics

CLIA Number: 06D2075332

Facility Name: SAFEWAY PHARMACY #1116

Facility Address:
1050 KEN PRATT BLVD
LONGMONT, CO
ZIP 80501
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Facility Phone Number: 303 682-0598

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1619908431

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	06D2075332
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY #1116
Street	1050 KEN PRATT BLVD
City	LONGMONT
State	CO
ZIP	80501
Phone	303 682-0598
CertificateType	4
CertificateEffectiveDate	11/10/2023
CertificateExpirationDate	11/9/2025
FacilityType	Waiver

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