45D2221863 CLIA NUMBER - CVS PHARMACY, INC CVS PHARMACY #07440

Laboratory Demographics

  • CLIA Code: 45D2221863
  • Facility Name: CVS PHARMACY, INC CVS PHARMACY #07440
  • Facility Address: 17410 MARSH LN
    DALLAS, TX
    ZIP 75287
  • Facility Phone: 401 765-1500
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHIOMA SIMON-EBUGHU
  • NPI Number: 1437253226
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2221863
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC CVS PHARMACY #07440
Street 17410 MARSH LN
City DALLAS
State TX
ZIP 75287
Phone 401 765-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Pharmacy
Lab Director CHIOMA SIMON-EBUGHU

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