06D2287415 CLIA NUMBER - WALGREENS 09393

Laboratory Demographics

  • CLIA Code: 06D2287415
  • Facility Name: WALGREENS 09393
  • Facility Address: 1609 FREMONT DR
    CANON CITY, CO
    ZIP 81212
  • Facility Phone: 719 275-1267
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREAH L. GIBSON
  • NPI Number: 1912625427
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 06D2287415
LAB Type Pharmacy
Facility Name WALGREENS 09393
Street 1609 FREMONT DR
City CANON CITY
State CO
ZIP 81212
Phone 719 275-1267
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Pharmacy
Lab Director ANDREAH L. GIBSON

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