45D2282788 CLIA NUMBER - CVS PHARMACY, INC DBA CVSPHARMACY #05976

Laboratory Demographics

  • CLIA Code: 45D2282788
  • Facility Name: CVS PHARMACY, INC DBA CVSPHARMACY #05976
  • Facility Address: 8560 S HULEN ST
    FORT WORTH, TX
    ZIP 76123
  • Facility Phone: (817) 292-0048
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICHOLAS ETAKA
  • NPI Number: 1144324971
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2282788
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVSPHARMACY #05976
Street 8560 S HULEN ST
City FORT WORTH
State TX
ZIP 76123
Phone 8172920048
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director NICHOLAS ETAKA

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This page was last updated on: 5/18/2026