06D2158864 CLIA NUMBER - WALMART PHARMACY 10-1019

Laboratory Demographics

  • CLIA Code: 06D2158864
  • Facility Name: WALMART PHARMACY 10-1019
  • Facility Address: 3105 E US HWY 50
    CANON CITY, CO
    ZIP 81212
  • Facility Phone: 719 275-1641
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALICIA M. HURST
  • NPI Number: 1386661643
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 06D2158864
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1019
Street 3105 E US HWY 50
City CANON CITY
State CO
ZIP 81212
Phone 719 275-1641
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Pharmacy
Lab Director ALICIA M. HURST

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025