45D2117149 CLIA NUMBER - WALMART PHARMACY 10-2979

Laboratory Demographics

  • CLIA Code: 45D2117149
  • Facility Name: WALMART PHARMACY 10-2979
  • Facility Address: 7401 PARK VISTA BLVD
    FORT WORTH, TX
    ZIP 76137
  • Facility Phone: 817 605-0404
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAMELA W. NJIKAM
  • NPI Number: 1215954342
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2117149
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2979
Street 7401 PARK VISTA BLVD
City FORT WORTH
State TX
ZIP 76137
Phone 817 605-0404
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Pharmacy
Lab Director PAMELA W. NJIKAM

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