45D2281370 CLIA NUMBER - CVS PHARMACY, INC DBA CVSPHARMACY #05255

Laboratory Demographics

  • CLIA Code: 45D2281370
  • Facility Name: CVS PHARMACY, INC DBA CVSPHARMACY #05255
  • Facility Address: 3401 ALTA MERE DR
    FORT WORTH, TX
    ZIP 76116
  • Facility Phone: 817 763-5133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MONICAH CAMPBELL
  • NPI Number: 1891893640
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2281370
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVSPHARMACY #05255
Street 3401 ALTA MERE DR
City FORT WORTH
State TX
ZIP 76116
Phone 817 763-5133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Pharmacy
Lab Director MONICAH CAMPBELL

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