06D2017504 CLIA NUMBER - KING SOOPERS #74

Laboratory Demographics

  • CLIA Code: 06D2017504
  • Facility Name: KING SOOPERS #74
  • Facility Address: 1275 EAGLE DR
    LOVELAND, CO
    ZIP 80537
  • Facility Phone: 970 663-2048
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY WARD
  • NPI Number: 1689619355
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2017504
LAB Type Pharmacy
Facility Name KING SOOPERS #74
Street 1275 EAGLE DR
City LOVELAND
State CO
ZIP 80537
Phone 970 663-2048
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2024
Certificate Expiration Date 12/12/2026
Facility Type Pharmacy
Lab Director KIMBERLY WARD

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