38D0991459 CLIA NUMBER - FRED MEYER PHARMACY #126

Laboratory Demographics

  • CLIA Code: 38D0991459
  • Facility Name: FRED MEYER PHARMACY #126
  • Facility Address: 1101 GRANTS PASS PARKWAY
    GRANTS PASS, OR
    ZIP 97526
  • Facility Phone: 541 474-7234
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THORESON BRANDON
  • NPI Number: 1841236486
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0991459
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #126
Street 1101 GRANTS PASS PARKWAY
City GRANTS PASS
State OR
ZIP 97526
Phone 541 474-7234
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 THORESON BRANDON

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