02D1042703 CLIA NUMBER - FRED MEYER PHARMACY #224

Laboratory Demographics

  • CLIA Code: 02D1042703
  • Facility Name: FRED MEYER PHARMACY #224
  • Facility Address: 930 OLD STEESE HIGHWAY
    FAIRBANKS, AK
    ZIP 99701
  • Facility Phone: 907 459-4233
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARY HEASTER
  • NPI Number: 1487699914
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 02D1042703
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #224
Street 930 OLD STEESE HIGHWAY
City FAIRBANKS
State AK
ZIP 99701
Phone 907 459-4233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2025
Certificate Expiration Date 7/5/2027
Facility Type Pharmacy
Lab Director MARY HEASTER

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