50D0950995 CLIA NUMBER - FRED MEYER PHARMACY #424

Laboratory Demographics

  • CLIA Code: 50D0950995
  • Facility Name: FRED MEYER PHARMACY #424
  • Facility Address: 17404 MERIDIAN E
    PUYALLUP, WA
    ZIP 98375
  • Facility Phone: (253) 445-7873
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEX WARDLE
  • NPI Number: 1588600027
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0950995
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #424
Street 17404 MERIDIAN E
City PUYALLUP
State WA
ZIP 98375
Phone 2534457873
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/1998
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director ALEX WARDLE

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This page was last updated on: 5/18/2026