45D2221980 CLIA NUMBER - CVS PHARMACY, INC DBA CVS PHARMACY #06966

Laboratory Demographics

  • CLIA Code: 45D2221980
  • Facility Name: CVS PHARMACY, INC DBA CVS PHARMACY #06966
  • Facility Address: 6004 SAMUELL BLVD
    DALLAS, TX
    ZIP 75228
  • Facility Phone: 401 770-6431
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHIBU GEORGE
  • NPI Number: 1093812497
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2221980
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVS PHARMACY #06966
Street 6004 SAMUELL BLVD
City DALLAS
State TX
ZIP 75228
Phone 401 770-6431
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 SHIBU GEORGE

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