02D1096638 CLIA NUMBER - FRED MEYER PHARMACY #017

Laboratory Demographics

  • CLIA Code: 02D1096638
  • Facility Name: FRED MEYER PHARMACY #017
  • Facility Address: 43843 STERLING ROAD
    SOLDOTNA, AK
    ZIP 99669
  • Facility Phone: 907 260-2233
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAYLA HENSLEY
  • NPI Number: 1578508008
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 02D1096638
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #017
Street 43843 STERLING ROAD
City SOLDOTNA
State AK
ZIP 99669
Phone 907 260-2233
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 KAYLA HENSLEY

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