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32D1033604 CLIA NUMBER - ALBERTSONS MARKET PHARMACY #690

Laboratory Demographics

CLIA Number: 32D1033604

Facility Name: ALBERTSONS MARKET PHARMACY #690

Facility Address:
1110 S MAIN STREET
ROSWELL, NM
ZIP 88201
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Facility Phone Number: 575 622-7039

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1679512057

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 32D1033604
LAB Type Pharmacy
Facility Name ALBERTSONS MARKET PHARMACY #690
Street 1110 S MAIN STREET
City ROSWELL
State NM
ZIP 88201
Phone 575 622-7039
CertificateType 4
CertificateEffectiveDate 11/15/2023
CertificateExpirationDate 11/14/2025
FacilityType Waiver

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