06D2219351 CLIA NUMBER - WALGREENS #12864

Laboratory Demographics

  • CLIA Code: 06D2219351
  • Facility Name: WALGREENS #12864
  • Facility Address: 490 ERIE PARKWAY
    ERIE, CO
    ZIP 80516
  • Facility Phone: 303 586-8276
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMBER D. MARTINEZ
  • NPI Number: 1912140633
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2219351
LAB Type Pharmacy
Facility Name WALGREENS #12864
Street 490 ERIE PARKWAY
City ERIE
State CO
ZIP 80516
Phone 303 586-8276
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director AMBER D. MARTINEZ

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