06D2045346 CLIA NUMBER - KING SOOPERS PHARMACY #114

Laboratory Demographics

  • CLIA Code: 06D2045346
  • Facility Name: KING SOOPERS PHARMACY #114
  • Facility Address: 15051 E 104TH AVE
    COMMERCE CITY, CO
    ZIP 80022
  • Facility Phone: 303 286-5470
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: KIMBERLY L. WARD
  • NPI Number: 1770841074
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2045346
LAB Type Other - RETAIL PHARMACY
Facility Name KING SOOPERS PHARMACY #114
Street 15051 E 104TH AVE
City COMMERCE CITY
State CO
ZIP 80022
Phone 303 286-5470
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Other - RETAIL PHARMACY
Lab Director KIMBERLY L. WARD

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