06D2121639 CLIA NUMBER - WAL-MART STORES, INC DBA - WALMART PHARMACY #10-3805

Laboratory Demographics

  • CLIA Code: 06D2121639
  • Facility Name: WAL-MART STORES, INC DBA - WALMART PHARMACY #10-3805
  • Facility Address: 19600 EAST US HIGHWAY 24
    WOODLAND PARK, CO
    ZIP 80863
  • Facility Phone: 719 687-4308
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TODD GROSSMAN
  • NPI Number: 1336348812
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 06D2121639
LAB Type Pharmacy
Facility Name WAL-MART STORES, INC DBA - WALMART PHARMACY #10-3805
Street 19600 EAST US HIGHWAY 24
City WOODLAND PARK
State CO
ZIP 80863
Phone 719 687-4308
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 TODD GROSSMAN

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