38D0991457 CLIA NUMBER - FRED MEYER PHARMACY #225

Laboratory Demographics

  • CLIA Code: 38D0991457
  • Facility Name: FRED MEYER PHARMACY #225
  • Facility Address: 2855 BROADWAY NE
    SALEM, OR
    ZIP 97303
  • Facility Phone: 503 391-2433
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. MELISSA RASCH
  • NPI Number: 1568407096
  • Taxonomy: 3336C0003X - Pharmacy

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2025
Certificate Expiration Date 9/19/2027
Facility Type Pharmacy
Lab Director MS. MELISSA RASCH

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