06D2128124 CLIA NUMBER - SAM'S CLUB PHARMACY #10-6634

Laboratory Demographics

  • CLIA Code: 06D2128124
  • Facility Name: SAM'S CLUB PHARMACY #10-6634
  • Facility Address: 7817 PARK MEADOWS DR
    LONE TREE, CO
    ZIP 80124
  • Facility Phone: 303 662-1720
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIMOTHY M. KWLLY
  • NPI Number: 1154419380
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 06D2128124
LAB Type Pharmacy
Facility Name SAM'S CLUB PHARMACY #10-6634
Street 7817 PARK MEADOWS DR
City LONE TREE
State CO
ZIP 80124
Phone 303 662-1720
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 TIMOTHY M. KWLLY

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