45D2119651 CLIA NUMBER - WALMART PHARMACY 10-3419

Laboratory Demographics

  • CLIA Code: 45D2119651
  • Facility Name: WALMART PHARMACY 10-3419
  • Facility Address: 6756 W VICKERY BLVD
    FORT WORTH, TX
    ZIP 76116
  • Facility Phone: 817 732-2195
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANNA TARAWNEH
  • NPI Number: 1366469421
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2119651
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-3419
Street 6756 W VICKERY BLVD
City FORT WORTH
State TX
ZIP 76116
Phone 817 732-2195
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Pharmacy
Lab Director DANNA TARAWNEH

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