06D2121612 CLIA NUMBER - WALMART PHARMACY #10-3018

Laboratory Demographics

  • CLIA Code: 06D2121612
  • Facility Name: WALMART PHARMACY #10-3018
  • Facility Address: 4425 VENETUCCI BLVD
    COLORADO SPRINGS, CO
    ZIP 80906
  • Facility Phone: 719 313-4385
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC H. SULLIVAN
  • NPI Number: 1528455953
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 06D2121612
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3018
Street 4425 VENETUCCI BLVD
City COLORADO SPRINGS
State CO
ZIP 80906
Phone 719 313-4385
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Pharmacy
Lab Director ERIC H. SULLIVAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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