45D2014746 CLIA NUMBER - WALGREENS #05270

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Laboratory Demographics

CLIA Number: 45D2014746

Facility Name: WALGREENS #05270

Facility Address:
3100 MCCART AVE
FORT WORTH, TX
ZIP 76110
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Facility Phone Number: 817 924-5126

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1114932183

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	45D2014746
LAB Type	Pharmacy
Facility Name	WALGREENS #05270
Street	3100 MCCART AVE
City	FORT WORTH
State	TX
ZIP	76110
Phone	817 924-5126
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024