38D0991456 CLIA NUMBER - FRED MEYER PHARMACY #281

Laboratory Demographics

  • CLIA Code: 38D0991456
  • Facility Name: FRED MEYER PHARMACY #281
  • Facility Address: 929 NW GARDEN VALLEY BLVD
    ROSEBURG, OR
    ZIP 97470
  • Facility Phone: 541 957-3058
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAYLA HENSLEY
  • NPI Number: 1033283569
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0991456
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #281
Street 929 NW GARDEN VALLEY BLVD
City ROSEBURG
State OR
ZIP 97470
Phone 541 957-3058
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2023
Certificate Expiration Date 9/19/2025
Facility Type Pharmacy
Lab Director KAYLA HENSLEY

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This page was last updated on: 6/4/2025