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50D0964101 CLIA NUMBER - FRED MEYER PHARMACY #172

Laboratory Demographics

CLIA Number: 50D0964101

Facility Name: FRED MEYER PHARMACY #172

Facility Address:
10201 SE 240TH
KENT, WA
ZIP 98031
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Facility Phone Number: 253 859-5533

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1912942442

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 50D0964101
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #172
Street 10201 SE 240TH
City KENT
State WA
ZIP 98031
Phone 253 859-5533
CertificateType 4
CertificateEffectiveDate 8/18/1999
CertificateExpirationDate 4/4/2028
FacilityType Waiver

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This page was last updated on: 4/23/2024