38D0971515 CLIA NUMBER - FRED MEYER PHARMACY #195

Laboratory Demographics

  • CLIA Code: 38D0971515
  • Facility Name: FRED MEYER PHARMACY #195
  • Facility Address: 2424 CRATER LAKE HIGHWAY
    MEDFORD, OR
    ZIP 97504
  • Facility Phone: 541 779-4153
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAYLA HENSLEY
  • NPI Number: 1003842733
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0971515
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #195
Street 2424 CRATER LAKE HIGHWAY
City MEDFORD
State OR
ZIP 97504
Phone 541 779-4153
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Pharmacy
Lab Director KAYLA HENSLEY

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