38D1100224 CLIA NUMBER - FRED MEYER PHARMACY #464

Laboratory Demographics

  • CLIA Code: 38D1100224
  • Facility Name: FRED MEYER PHARMACY #464
  • Facility Address: 4701 HWY 101
    FLORENCE, OR
    ZIP 97439
  • Facility Phone: 541 902-7333
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDON THORESON
  • NPI Number: 1740223957
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D1100224
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #464
Street 4701 HWY 101
City FLORENCE
State OR
ZIP 97439
Phone 541 902-7333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Pharmacy
Lab Director BRANDON THORESON

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