45D2117227 CLIA NUMBER - WALMART PHARMACY 10-3135

Laboratory Demographics

  • CLIA Code: 45D2117227
  • Facility Name: WALMART PHARMACY 10-3135
  • Facility Address: 717 W BERRY STREET
    FORT WORTH, TX
    ZIP 76110
  • Facility Phone: 817 840-0263
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KHANH Q. LE
  • NPI Number: 1275872756
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2117227
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3135
Street 717 W BERRY STREET
City FORT WORTH
State TX
ZIP 76110
Phone 817 840-0263
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Pharmacy
Lab Director KHANH Q. LE

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