13D1010066 CLIA NUMBER - FRED MEYER PHARMACY #226

Laboratory Demographics

CLIA Number: 13D1010066

Facility Name: FRED MEYER PHARMACY #226

Facility Address:
50 2ND ST S
NAMPA, ID
ZIP 83651
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Facility Phone Number: 208 465-2836

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1225074131

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	13D1010066
LAB Type	Pharmacy
Facility Name	FRED MEYER PHARMACY #226
Street	50 2ND ST S
City	NAMPA
State	ID
ZIP	83651
Phone	208 465-2836
CertificateType	4
CertificateEffectiveDate	3/5/2023
CertificateExpirationDate	3/4/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024