06D2225752 CLIA NUMBER - WALGREENS #12769

Laboratory Demographics

  • CLIA Code: 06D2225752
  • Facility Name: WALGREENS #12769
  • Facility Address: 265 W HIGHWAY 105
    MONUMENT, CO
    ZIP 80132
  • Facility Phone: 719 219-1288
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHAWN WILLIAMS
  • NPI Number: 1326377714
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2225752
LAB Type Pharmacy
Facility Name WALGREENS #12769
Street 265 W HIGHWAY 105
City MONUMENT
State CO
ZIP 80132
Phone 719 219-1288
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Pharmacy
Lab Director SHAWN WILLIAMS

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