06D2017510 CLIA NUMBER - KING SOOPERS #80

Laboratory Demographics

  • CLIA Code: 06D2017510
  • Facility Name: KING SOOPERS #80
  • Facility Address: 995 S HOVER ST
    LONGMONT, CO
    ZIP 80501
  • Facility Phone: (303) 702-0089
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY WARD
  • NPI Number: 1730116260
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2017510
LAB Type Pharmacy
Facility Name KING SOOPERS #80
Street 995 S HOVER ST
City LONGMONT
State CO
ZIP 80501
Phone 3037020089
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: 5/18/2026