45D2061496 CLIA NUMBER - WALGREENS #4857

Laboratory Demographics

  • CLIA Code: 45D2061496
  • Facility Name: WALGREENS #4857
  • Facility Address: 4921 BRYANT IRVIN RD
    FORT WORTH, TX
    ZIP 76132
  • Facility Phone: 817 292-5806
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CODY CRIBBS
  • NPI Number: 1841205895
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2061496
LAB Type Pharmacy
Facility Name WALGREENS #4857
Street 4921 BRYANT IRVIN RD
City FORT WORTH
State TX
ZIP 76132
Phone 817 292-5806
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Pharmacy
Lab Director CODY CRIBBS

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