45D2282832 CLIA NUMBER - CVS PHARMACY, INC DBA CVSPHARMACY #10489

Laboratory Demographics

  • CLIA Code: 45D2282832
  • Facility Name: CVS PHARMACY, INC DBA CVSPHARMACY #10489
  • Facility Address: 8601 BOAT CLUB RD
    FORT WORTH, TX
    ZIP 76179
  • Facility Phone: 817 236-0186
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIFFANY OGWU
  • NPI Number: 1265836324
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2282832
LAB Type Pharmacy
Facility Name CVS PHARMACY, INC DBA CVSPHARMACY #10489
Street 8601 BOAT CLUB RD
City FORT WORTH
State TX
ZIP 76179
Phone 817 236-0186
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Pharmacy
Lab Director TIFFANY OGWU

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