38D0971542 CLIA NUMBER - FRED MEYER PHARMACY #377

Laboratory Demographics

  • CLIA Code: 38D0971542
  • Facility Name: FRED MEYER PHARMACY #377
  • Facility Address: 2500 NORTH MAIN ST
    TILLAMOOK, OR
    ZIP 97141
  • Facility Phone: 503 815-1433
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: IAN WOOD
  • NPI Number: 1891730289
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0971542
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #377
Street 2500 NORTH MAIN ST
City TILLAMOOK
State OR
ZIP 97141
Phone 503 815-1433
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 IAN WOOD

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