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06D2174635 CLIA NUMBER - RIDLEY'S PHARMACY #1136

Laboratory Demographics

CLIA Number: 06D2174635

Facility Name: RIDLEY'S PHARMACY #1136

Facility Address:
7670 5TH STREET
WELLINGTON, CO
ZIP 80549
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Facility Phone Number: 970 825-7038

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1831619089

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 06D2174635
LAB Type Pharmacy
Facility Name RIDLEY'S PHARMACY #1136
Street 7670 5TH STREET
City WELLINGTON
State CO
ZIP 80549
Phone 970 825-7038
CertificateType 4
CertificateEffectiveDate 11/5/2023
CertificateExpirationDate 11/4/2025
FacilityType Waiver

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