50D0955138 CLIA NUMBER - FRED MEYER PHARMACY #179

Laboratory Demographics

  • CLIA Code: 50D0955138
  • Facility Name: FRED MEYER PHARMACY #179
  • Facility Address: 13000 LAKE CITY WY NE
    SEATTLE, WA
    ZIP 98125
  • Facility Phone: 206 440-2433
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LEONILLA VILLANEUVA
  • NPI Number: 1306882840
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0955138
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #179
Street 13000 LAKE CITY WY NE
City SEATTLE
State WA
ZIP 98125
Phone 206 440-2433
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/1998
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director LEONILLA VILLANEUVA

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This page was last updated on: 6/4/2025