06D2017555 CLIA NUMBER - CITY MARKET #404

Laboratory Demographics

  • CLIA Code: 06D2017555
  • Facility Name: CITY MARKET #404
  • Facility Address: 122 GUNNISON RIVER DR
    DELTA, CO
    ZIP 81416
  • Facility Phone: 970 874-5771
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY WARD
  • NPI Number: 1598791857
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2017555
LAB Type Pharmacy
Facility Name CITY MARKET #404
Street 122 GUNNISON RIVER DR
City DELTA
State CO
ZIP 81416
Phone 970 874-5771
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