45D2061509 CLIA NUMBER - WALGREENS #04314

Laboratory Demographics

  • CLIA Code: 45D2061509
  • Facility Name: WALGREENS #04314
  • Facility Address: 6346 CAMP BOWIE BLVD
    FORT WORTH, TX
    ZIP 76116
  • Facility Phone: 817 377-9095
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMGAD AWAD
  • NPI Number: 1184631129
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2061509
LAB Type Pharmacy
Facility Name WALGREENS #04314
Street 6346 CAMP BOWIE BLVD
City FORT WORTH
State TX
ZIP 76116
Phone 817 377-9095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Pharmacy
Lab Director AMGAD AWAD

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