50D0964100 CLIA NUMBER - FRED MEYER PHARMACY #19

Laboratory Demographics

  • CLIA Code: 50D0964100
  • Facility Name: FRED MEYER PHARMACY #19
  • Facility Address: 801 AUBURN WAY N
    AUBURN, WA
    ZIP 98002
  • Facility Phone: 253 931-5584
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAULA WONG
  • NPI Number: 1124064662
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0964100
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #19
Street 801 AUBURN WAY N
City AUBURN
State WA
ZIP 98002
Phone 253 931-5584
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 PAULA WONG

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