50D0964311 CLIA NUMBER - FRED MEYER PHARMACY #111

Laboratory Demographics

  • CLIA Code: 50D0964311
  • Facility Name: FRED MEYER PHARMACY #111
  • Facility Address: 33702 21ST AVE SW
    FEDERAL WAY, WA
    ZIP 98023
  • Facility Phone: 253 952-0133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PETER CHIN
  • NPI Number: 1942246483
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0964311
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #111
Street 33702 21ST AVE SW
City FEDERAL WAY
State WA
ZIP 98023
Phone 253 952-0133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/1999
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director PETER CHIN

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