02D1096635 CLIA NUMBER - FRED MEYER PHARMACY #649

Laboratory Demographics

  • CLIA Code: 02D1096635
  • Facility Name: FRED MEYER PHARMACY #649
  • Facility Address: 535 E PALMER-WASILLA HWY
    PALMER, AK
    ZIP 99645
  • Facility Phone: 907 707-0433
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ABDI OSMAN
  • NPI Number: 1922043454
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 02D1096635
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #649
Street 535 E PALMER-WASILLA HWY
City PALMER
State AK
ZIP 99645
Phone 907 707-0433
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Pharmacy
Lab Director ABDI OSMAN

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