45D2221986 CLIA NUMBER - CVS PHARMACY, INC DBA CVS PHARMACY #07631

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Laboratory Demographics

CLIA Number: 45D2221986

Facility Name: CVS PHARMACY, INC DBA CVS PHARMACY #07631

Facility Address:
2603 W BERRY ST
FORT WORTH, TX
ZIP 76109
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Facility Phone Number: 401 765-1500

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1831293638

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	45D2221986
LAB Type	Pharmacy
Facility Name	CVS PHARMACY, INC DBA CVS PHARMACY #07631
Street	2603 W BERRY ST
City	FORT WORTH
State	TX
ZIP	76109
Phone	401 765-1500
CertificateType	4
CertificateEffectiveDate	4/26/2023
CertificateExpirationDate	4/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024