45D2117041 CLIA NUMBER - WALMART PHARMACY 10-590

Laboratory Demographics

  • CLIA Code: 45D2117041
  • Facility Name: WALMART PHARMACY 10-590
  • Facility Address: 6300 OAKMONT BLVD
    FORT WORTH, TX
    ZIP 76132
  • Facility Phone: 817 263-6572
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOYCE B. FORLEMU
  • NPI Number: 1407874241
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2117041
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-590
Street 6300 OAKMONT BLVD
City FORT WORTH
State TX
ZIP 76132
Phone 817 263-6572
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Pharmacy
Lab Director JOYCE B. FORLEMU

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