45D2281461 CLIA NUMBER - CVS PHARMACY, INC DBA CVSPHARMACY #07421

Laboratory Demographics

  • CLIA Code: 45D2281461
  • Facility Name: CVS PHARMACY, INC DBA CVSPHARMACY #07421
  • Facility Address: 810 W PIONEER PKWY
    GRAND PRAIRIE, TX
    ZIP 75051
  • Facility Phone: 972 641-5744
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HERVE POLA
  • NPI Number: 1508960394
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2281461
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVSPHARMACY #07421
Street 810 W PIONEER PKWY
City GRAND PRAIRIE
State TX
ZIP 75051
Phone 972 641-5744
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 HERVE POLA

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This page was last updated on: 6/4/2025