45D2119179 CLIA NUMBER - WALMART PHARMACY 10-5359

Laboratory Demographics

  • CLIA Code: 45D2119179
  • Facility Name: WALMART PHARMACY 10-5359
  • Facility Address: 721 BOYD ROAD
    AZLE, TX
    ZIP 76020
  • Facility Phone: 817 270-5838
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HANNAH E. BIBENS
  • NPI Number: 1396762522
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2119179
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-5359
Street 721 BOYD ROAD
City AZLE
State TX
ZIP 76020
Phone 817 270-5838
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Pharmacy
Lab Director HANNAH E. BIBENS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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