45D2281379 CLIA NUMBER - CVS PHARMACY, INC DBA CVSPHARMACY #06817

Laboratory Demographics

  • CLIA Code: 45D2281379
  • Facility Name: CVS PHARMACY, INC DBA CVSPHARMACY #06817
  • Facility Address: 6548 MEADOWBROOK DR PHARMACIST
    FORT WORTH, TX
    ZIP 76112
  • Facility Phone: 817 457-3680
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DIVINE NYIAWUNG
  • NPI Number: 1184728990
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2281379
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVSPHARMACY #06817
Street 6548 MEADOWBROOK DR PHARMACIST
City FORT WORTH
State TX
ZIP 76112
Phone 817 457-3680
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 DIVINE NYIAWUNG

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