06D2128395 CLIA NUMBER - WALMART PHARMACY #10-2752

Laboratory Demographics

  • CLIA Code: 06D2128395
  • Facility Name: WALMART PHARMACY #10-2752
  • Facility Address: 5990 DAHLIA ST
    COMMERCE CITY, CO
    ZIP 80022
  • Facility Phone: 479 258-7034
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARTIN A. KISANG
  • NPI Number: 1447277728
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2128395
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-2752
Street 5990 DAHLIA ST
City COMMERCE CITY
State CO
ZIP 80022
Phone 479 258-7034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Pharmacy
Lab Director MARTIN A. KISANG

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