50D0961171 CLIA NUMBER - FRED MEYER PHARMACY #140

Laboratory Demographics

  • CLIA Code: 50D0961171
  • Facility Name: FRED MEYER PHARMACY #140
  • Facility Address: 7700 HIGHWAY 99
    VANCOUVER, WA
    ZIP 98665
  • Facility Phone: 360 695-1243
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: RYAN WIMMERS
  • NPI Number: 1730125642
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0961171
LAB Type Mobile Laboratory
Facility Name FRED MEYER PHARMACY #140
Street 7700 HIGHWAY 99
City VANCOUVER
State WA
ZIP 98665
Phone 360 695-1243
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/1999
Certificate Expiration Date 4/4/2028
Facility Type Mobile Laboratory
Lab Director RYAN WIMMERS

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