45D2117863 CLIA NUMBER - WALMART PHARMACY 10-5312

Laboratory Demographics

  • CLIA Code: 45D2117863
  • Facility Name: WALMART PHARMACY 10-5312
  • Facility Address: 3851 AIRPORT FREEWAY
    FORT WORTH, TX
    ZIP 76111
  • Facility Phone: 817 759-1926
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PRAKASH RAJ THAPALIYA
  • NPI Number: 1669555272
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D2117863
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5312
Street 3851 AIRPORT FREEWAY
City FORT WORTH
State TX
ZIP 76111
Phone 817 759-1926
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type Pharmacy
Lab Director PRAKASH RAJ THAPALIYA

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