13D0985335 CLIA NUMBER - FRED MEYER PHARMACY #613

Laboratory Demographics

  • CLIA Code: 13D0985335
  • Facility Name: FRED MEYER PHARMACY #613
  • Facility Address: 3527 S FEDERAL WAY
    BOISE, ID
    ZIP 83705
  • Facility Phone: 208 424-7533
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ABDI Y. OSMAN PHARM D
  • NPI Number: 1902842594
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D0985335
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #613
Street 3527 S FEDERAL WAY
City BOISE
State ID
ZIP 83705
Phone 208 424-7533
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director ABDI Y. OSMAN PHARM D

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