45D2281442 CLIA NUMBER - CVS PHARMACY, INC DBA CVSPHARMACY #07642

Laboratory Demographics

  • CLIA Code: 45D2281442
  • Facility Name: CVS PHARMACY, INC DBA CVSPHARMACY #07642
  • Facility Address: 6640 LAKE WORTH BLVD
    LAKE WORTH, TX
    ZIP 76135
  • Facility Phone: 817 237-3363
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAUREENA SAM
  • NPI Number: 1659475457
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2281442
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVSPHARMACY #07642
Street 6640 LAKE WORTH BLVD
City LAKE WORTH
State TX
ZIP 76135
Phone 817 237-3363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/8/2025
Certificate Expiration Date 5/7/2027
Facility Type Pharmacy
Lab Director MAUREENA SAM

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