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38D0954470 CLIA NUMBER - FRED MEYER PHARMACY #417

Laboratory Demographics

CLIA Number: 38D0954470

Facility Name: FRED MEYER PHARMACY #417

Facility Address:
3333 WEST 11TH AVE
EUGENE, OR
ZIP 97402
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Facility Phone Number: 541 345-9477

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1114953320

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 38D0954470
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #417
Street 3333 WEST 11TH AVE
City EUGENE
State OR
ZIP 97402
Phone 541 345-9477
CertificateType 4
CertificateEffectiveDate 1/1/2024
CertificateExpirationDate 12/31/2025
FacilityType Waiver

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