45D2281383 CLIA NUMBER - CVS PHARMACY, INC DBA CVSPHARMACY #06775

Laboratory Demographics

  • CLIA Code: 45D2281383
  • Facility Name: CVS PHARMACY, INC DBA CVSPHARMACY #06775
  • Facility Address: 701 E MAIN ST
    GRAND PRAIRIE, TX
    ZIP 75050
  • Facility Phone: 972 264-2371
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERICA KIM
  • NPI Number: 1720182538
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2281383
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVSPHARMACY #06775
Street 701 E MAIN ST
City GRAND PRAIRIE
State TX
ZIP 75050
Phone 972 264-2371
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 ERICA KIM

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