06D2121616 CLIA NUMBER - WALMART PHARMACY #10-4284

Laboratory Demographics

  • CLIA Code: 06D2121616
  • Facility Name: WALMART PHARMACY #10-4284
  • Facility Address: 440 WADSWORTH BLVD
    LAKEWOOD, CO
    ZIP 80226
  • Facility Phone: 303 205-0766
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANNON M. WATHEN
  • NPI Number: 1811052004
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2121616
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-4284
Street 440 WADSWORTH BLVD
City LAKEWOOD
State CO
ZIP 80226
Phone 303 205-0766
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 SHANNON M. WATHEN

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