06D2155970 CLIA NUMBER - WALMART PHARMACY #10-4639

Laboratory Demographics

  • CLIA Code: 06D2155970
  • Facility Name: WALMART PHARMACY #10-4639
  • Facility Address: 2100 LEGACY CIR
    ELIZABETH, CO
    ZIP 80107
  • Facility Phone: 303 646-2289
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LASHELL C. SCOTT
  • NPI Number: 1427285345
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2155970
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-4639
Street 2100 LEGACY CIR
City ELIZABETH
State CO
ZIP 80107
Phone 303 646-2289
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2024
Certificate Expiration Date 10/8/2026
Facility Type Pharmacy
Lab Director LASHELL C. SCOTT

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