50D0964099 CLIA NUMBER - FRED MEYER PHARMACY #265

Laboratory Demographics

  • CLIA Code: 50D0964099
  • Facility Name: FRED MEYER PHARMACY #265
  • Facility Address: 1100 N MERIDIAN
    PUYALLUP, WA
    ZIP 98371
  • Facility Phone: 253 840-8183
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATEL MUKESH
  • NPI Number: 1386689818
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0964099
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #265
Street 1100 N MERIDIAN
City PUYALLUP
State WA
ZIP 98371
Phone 253 840-8183
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/1999
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director PATEL MUKESH

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