06D2155974 CLIA NUMBER - WALMART PHARMACY #10-3175

Laboratory Demographics

  • CLIA Code: 06D2155974
  • Facility Name: WALMART PHARMACY #10-3175
  • Facility Address: 4142 AUSTIN BLUFFS PARKWAY
    COLORADO SPRINGS, CO
    ZIP 80918
  • Facility Phone: 719 244-9783
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TYLER GRAWE
  • NPI Number: 1205269701
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2155974
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3175
Street 4142 AUSTIN BLUFFS PARKWAY
City COLORADO SPRINGS
State CO
ZIP 80918
Phone 719 244-9783
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 TYLER GRAWE

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