06D2128093 CLIA NUMBER - SAM'S CLUB PHARMACY #10-4777

Laboratory Demographics

  • CLIA Code: 06D2128093
  • Facility Name: SAM'S CLUB PHARMACY #10-4777
  • Facility Address: 7805 E 35TH AVE
    DENVER, CO
    ZIP 80238
  • Facility Phone: 720 941-7146
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GERRIT DEHAAS
  • NPI Number: 1396820239
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 06D2128093
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY #10-4777
Street 7805 E 35TH AVE
City DENVER
State CO
ZIP 80238
Phone 720 941-7146
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director GERRIT DEHAAS

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