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

Laboratory Demographics

  • CLIA Code: 45D2221986
  • Facility Name: CVS PHARMACY, INC DBA CVS PHARMACY #07631
  • Facility Address: 2603 W BERRY ST
    FORT WORTH, TX
    ZIP 76109
  • Facility Phone: 401 765-1500
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BENJAMIN QUAYE
  • NPI Number: 1831293638
  • Taxonomy: 333600000X - Pharmacy

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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
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 BENJAMIN QUAYE

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