45D2224002 CLIA NUMBER - CVS PHARMACY, INC DBA CVS PHARMACY #07489

Laboratory Demographics

  • CLIA Code: 45D2224002
  • Facility Name: CVS PHARMACY, INC DBA CVS PHARMACY #07489
  • Facility Address: 100 SW WILSHIRE BLVD
    BURLESON, TX
    ZIP 76028
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TYRRELL MOORE
  • NPI Number: 1679595342
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2224002
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVS PHARMACY #07489
Street 100 SW WILSHIRE BLVD
City BURLESON
State TX
ZIP 76028
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director TYRRELL MOORE

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