13D2046436 CLIA NUMBER - FRED MEYER PHARMACY #685

Laboratory Demographics

  • CLIA Code: 13D2046436
  • Facility Name: FRED MEYER PHARMACY #685
  • Facility Address: 1400 W CHINDEN BLVD
    MERIDIAN, ID
    ZIP 83646
  • Facility Phone: 208 893-6033
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JIM WOOD
  • NPI Number: 1508132069
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2046436
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #685
Street 1400 W CHINDEN BLVD
City MERIDIAN
State ID
ZIP 83646
Phone 208 893-6033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/4/2024
Certificate Expiration Date 9/3/2026
Facility Type Pharmacy
Lab Director JIM WOOD

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