50D0964312 CLIA NUMBER - FRED MEYER PHARMACY #209

Laboratory Demographics

  • CLIA Code: 50D0964312
  • Facility Name: FRED MEYER PHARMACY #209
  • Facility Address: 9925 STATE AVE
    MARYSVILLE, WA
    ZIP 98270
  • Facility Phone: 360 653-0733
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JARED LAYMAN
  • NPI Number: 1366487431
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0964312
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #209
Street 9925 STATE AVE
City MARYSVILLE
State WA
ZIP 98270
Phone 360 653-0733
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 JARED LAYMAN

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