38D0991457 CLIA NUMBER - FRED MEYER PHARMACY #225

Laboratory Demographics

CLIA Number: 38D0991457

Facility Name: FRED MEYER PHARMACY #225

Facility Address:
2855 BROADWAY NE
SALEM, OR
ZIP 97303
Get Directions

Facility Phone Number: 503 391-2433

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1568407096

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	38D0991457
LAB Type	Pharmacy
Facility Name	FRED MEYER PHARMACY #225
Street	2855 BROADWAY NE
City	SALEM
State	OR
ZIP	97303
Phone	503 391-2433
CertificateType	4
CertificateEffectiveDate	9/20/2023
CertificateExpirationDate	9/19/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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