45D2119697 CLIA NUMBER - WALMART PHARMACY 10-1455

Laboratory Demographics

  • CLIA Code: 45D2119697
  • Facility Name: WALMART PHARMACY 10-1455
  • Facility Address: 8401 ANDERSON BLVD
    FORT WORTH, TX
    ZIP 76120
  • Facility Phone: 817 276-9041
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BABATUNDE BOLARINWA
  • NPI Number: 1780601948
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2119697
LAB Type Pharmacy
Facility Name WALMART PHARMACY 10-1455
Street 8401 ANDERSON BLVD
City FORT WORTH
State TX
ZIP 76120
Phone 817 276-9041
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Pharmacy
Lab Director BABATUNDE BOLARINWA

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