06D2133076 CLIA NUMBER - WALMART PHARMACY 10-5828

Laboratory Demographics

  • CLIA Code: 06D2133076
  • Facility Name: WALMART PHARMACY 10-5828
  • Facility Address: 2730 S PRAIRIE
    PUEBLO, CO
    ZIP 81005
  • Facility Phone: 719 696-6159
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL DECOCK
  • NPI Number: 1285093476
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2133076
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5828
Street 2730 S PRAIRIE
City PUEBLO
State CO
ZIP 81005
Phone 719 696-6159
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2025
Certificate Expiration Date 7/4/2027
Facility Type Pharmacy
Lab Director DANIEL DECOCK

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