50D0951173 CLIA NUMBER - FRED MEYER PHARMACY #23

Laboratory Demographics

  • CLIA Code: 50D0951173
  • Facility Name: FRED MEYER PHARMACY #23
  • Facility Address: 2041 148TH NE
    BELLEVUE, WA
    ZIP 98007
  • Facility Phone: (425) 865-8593
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PARASIMA KHERADMANED
  • NPI Number: 1386718815
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0951173
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #23
Street 2041 148TH NE
City BELLEVUE
State WA
ZIP 98007
Phone 4258658593
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/1998
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director PARASIMA KHERADMANED

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