06D2155982 CLIA NUMBER - WALMART PHARMACY #10-3382

Laboratory Demographics

  • CLIA Code: 06D2155982
  • Facility Name: WALMART PHARMACY #10-3382
  • Facility Address: 78 N MCCULLOCH BLVD
    PUEBLO WEST, CO
    ZIP 81007
  • Facility Phone: (719) 647-9923
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER CHRISTIANSEN
  • NPI Number: 1851458236
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2155982
LAB Type Pharmacy
Facility Name WALMART PHARMACY #10-3382
Street 78 N MCCULLOCH BLVD
City PUEBLO WEST
State CO
ZIP 81007
Phone 7196479923
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 CHRISTOPHER CHRISTIANSEN

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This page was last updated on: 5/18/2026