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45D2222146 CLIA NUMBER - CVS PHARMACY, INC DBA CVS PHARMACY #07575

Laboratory Demographics

CLIA Number: 45D2222146

Facility Name: CVS PHARMACY, INC DBA CVS PHARMACY #07575

Facility Address:
5012 TRAIL LAKE DR
FORT WORTH, TX
ZIP 76133
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1487751889

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 45D2222146
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVS PHARMACY #07575
Street 5012 TRAIL LAKE DR
City FORT WORTH
State TX
ZIP 76133
Phone 401 770-6431
CertificateType 4
CertificateEffectiveDate 4/27/2023
CertificateExpirationDate 4/26/2025
FacilityType Waiver

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