50D0951633 CLIA NUMBER - FRED MEYER PHARMARY #603

Laboratory Demographics

  • CLIA Code: 50D0951633
  • Facility Name: FRED MEYER PHARMARY #603
  • Facility Address: 301 E WALLACE-KNEELAND BLVD
    SHELTON, WA
    ZIP 98584
  • Facility Phone: 360 432-5373
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: UMA AYYAGARI
  • NPI Number: 1003852641
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0951633
LAB Type Pharmacy
Facility Name FRED MEYER PHARMARY #603
Street 301 E WALLACE-KNEELAND BLVD
City SHELTON
State WA
ZIP 98584
Phone 360 432-5373
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/1998
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director UMA AYYAGARI

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