06D2128099 CLIA NUMBER - SAM'S CLUB PHARMACY #10-6219

Laboratory Demographics

  • CLIA Code: 06D2128099
  • Facility Name: SAM'S CLUB PHARMACY #10-6219
  • Facility Address: 1850 E WOODMEN RD
    COLORADO SPRINGS, CO
    ZIP 80920
  • Facility Phone: 719 277-0553
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSICA BAILEY
  • NPI Number: 1386732873
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 06D2128099
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY #10-6219
Street 1850 E WOODMEN RD
City COLORADO SPRINGS
State CO
ZIP 80920
Phone 719 277-0553
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 JESSICA BAILEY

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