06D2017524 CLIA NUMBER - KING SOOPERS #91

Laboratory Demographics

  • CLIA Code: 06D2017524
  • Facility Name: KING SOOPERS #91
  • Facility Address: 7284 LAGAE RD
    CASTLE ROCK, CO
    ZIP 80108
  • Facility Phone: 303 688-9721
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY WARD
  • NPI Number: 1417983602
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2017524
LAB Type Pharmacy
Facility Name KING SOOPERS #91
Street 7284 LAGAE RD
City CASTLE ROCK
State CO
ZIP 80108
Phone 303 688-9721
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