45D2117394 CLIA NUMBER - WALMART PHARMACY 10-5080

Laboratory Demographics

  • CLIA Code: 45D2117394
  • Facility Name: WALMART PHARMACY 10-5080
  • Facility Address: 1732 PRECINCT LINE ROAD
    HURST, TX
    ZIP 76054
  • Facility Phone: 817 503-7731
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LILY NGUYEN
  • NPI Number: 1295752343
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2117394
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5080
Street 1732 PRECINCT LINE ROAD
City HURST
State TX
ZIP 76054
Phone 817 503-7731
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Pharmacy
Lab Director LILY NGUYEN

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