32D2010908 CLIA NUMBER - SAFEWAY INC PHARMACY #2004

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Laboratory Demographics

CLIA Number: 32D2010908

Facility Name: SAFEWAY INC PHARMACY #2004

Facility Address:
3540 E MAIN ST
FARMINGTON, NM
ZIP 87401
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Facility Phone Number: 505 564-3086

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1003852864

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	32D2010908
LAB Type	Pharmacy
Facility Name	SAFEWAY INC PHARMACY #2004
Street	3540 E MAIN ST
City	FARMINGTON
State	NM
ZIP	87401
Phone	505 564-3086
CertificateType	4
CertificateEffectiveDate	3/28/2024
CertificateExpirationDate	3/27/2026
FacilityType	Waiver

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