50D0961176 CLIA NUMBER - FRED MEYER PHARMACY #236

Laboratory Demographics

  • CLIA Code: 50D0961176
  • Facility Name: FRED MEYER PHARMACY #236
  • Facility Address: 7411 NE 117TH AVENUE
    VANCOUVER, WA
    ZIP 98662
  • Facility Phone: 360 896-3533
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RONALD KUIPER
  • NPI Number: 1437194826
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0961176
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #236
Street 7411 NE 117TH AVENUE
City VANCOUVER
State WA
ZIP 98662
Phone 360 896-3533
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 Pharmacy
Lab Director RONALD KUIPER

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