06D2225889 CLIA NUMBER - WALGREENS #04709

Laboratory Demographics

  • CLIA Code: 06D2225889
  • Facility Name: WALGREENS #04709
  • Facility Address: 280 MAIN ST
    SECURITY, CO
    ZIP 80911
  • Facility Phone: 719 390-9123
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CORY R. BURMEISTER
  • NPI Number: 1811902158
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2225889
LAB Type Pharmacy
Facility Name WALGREENS #04709
Street 280 MAIN ST
City SECURITY
State CO
ZIP 80911
Phone 719 390-9123
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director CORY R. BURMEISTER

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