45D2111767 CLIA NUMBER - PRIME CARE PHARMACY

Laboratory Demographics

  • CLIA Code: 45D2111767
  • Facility Name: PRIME CARE PHARMACY
  • Facility Address: 611 WEST MAIN STREET
    ARLINGTON, TX
    ZIP 76010
  • Facility Phone: 817 996-1092
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AUGUSTA AHARANWA
  • NPI Number: 1841653060
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2111767
LAB Type Pharmacy
Facility Name PRIME CARE PHARMACY
Street 611 WEST MAIN STREET
City ARLINGTON
State TX
ZIP 76010
Phone 817 996-1092
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Pharmacy
Lab Director AUGUSTA AHARANWA

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