06D2017591 CLIA NUMBER - CITY MARKET #445

Laboratory Demographics

  • CLIA Code: 06D2017591
  • Facility Name: CITY MARKET #445
  • Facility Address: 165 COUNTRY CENTER DR
    PAGOSA SPRINGS, CO
    ZIP 81147
  • Facility Phone: 970 731-6006
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY WARD
  • NPI Number: 1508892795
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2017591
LAB Type Pharmacy
Facility Name CITY MARKET #445
Street 165 COUNTRY CENTER DR
City PAGOSA SPRINGS
State CO
ZIP 81147
Phone 970 731-6006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Pharmacy
Lab Director KIMBERLY WARD

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