45D2281401 CLIA NUMBER - CVS PHARMACY, INC DBA CVSPHARMACY #00485

Laboratory Demographics

  • CLIA Code: 45D2281401
  • Facility Name: CVS PHARMACY, INC DBA CVSPHARMACY #00485
  • Facility Address: 1233 PRECINCT LINE RD
    HURST, TX
    ZIP 76053
  • Facility Phone: 817 595-2484
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHAITANYA KODURU
  • NPI Number: 1417133844
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2281401
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVSPHARMACY #00485
Street 1233 PRECINCT LINE RD
City HURST
State TX
ZIP 76053
Phone 817 595-2484
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 CHAITANYA KODURU

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