45D2119213 CLIA NUMBER - WALMART PHARMACY 10-2978

Laboratory Demographics

  • CLIA Code: 45D2119213
  • Facility Name: WALMART PHARMACY 10-2978
  • Facility Address: 7451 MCCART AVENUE
    FORT WORTH, TX
    ZIP 76133
  • Facility Phone: 817 361-7284
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BARUN K. BOUVIA
  • NPI Number: 1578580601
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2119213
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-2978
Street 7451 MCCART AVENUE
City FORT WORTH
State TX
ZIP 76133
Phone 817 361-7284
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 BARUN K. BOUVIA

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