45D2182631 CLIA NUMBER - SUNDANCE APOTHECARY, LP

Laboratory Demographics

  • CLIA Code: 45D2182631
  • Facility Name: SUNDANCE APOTHECARY, LP
  • Facility Address: 201 COMMERCE ST SUITE 201
    FORT WORTH, TX
    ZIP 76102
  • Facility Phone: 682 285-1100
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXANDER ATKINS
  • NPI Number: 1225510795
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2182631
LAB Type Pharmacy
Facility Name SUNDANCE APOTHECARY, LP
Street 201 COMMERCE ST SUITE 201
City FORT WORTH
State TX
ZIP 76102
Phone 682 285-1100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2024
Certificate Expiration Date 4/22/2026
Facility Type Pharmacy
Lab Director ALEXANDER ATKINS

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