50D0964537 CLIA NUMBER - FRED MEYER PHARMACY #13

Laboratory Demographics

CLIA Number: 50D0964537

Facility Name: FRED MEYER PHARMACY #13

Facility Address:
18325 AURORA AVE N
SHORELINE, WA
ZIP 98133
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Facility Phone Number: 253 546-0753

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1770529216

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	50D0964537
LAB Type	Pharmacy
Facility Name	FRED MEYER PHARMACY #13
Street	18325 AURORA AVE N
City	SHORELINE
State	WA
ZIP	98133
Phone	253 546-0753
CertificateType	4
CertificateEffectiveDate	8/26/1999
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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