50D0965106 CLIA NUMBER - FRED MEYER PHARMACY #210

Laboratory Demographics

  • CLIA Code: 50D0965106
  • Facility Name: FRED MEYER PHARMACY #210
  • Facility Address: 18805 STATE ROUTE 2
    MONROE, WA
    ZIP 98272
  • Facility Phone: 360 805-8133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL TEMPLETON
  • NPI Number: 1760428205
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D0965106
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #210
Street 18805 STATE ROUTE 2
City MONROE
State WA
ZIP 98272
Phone 360 805-8133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/1999
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director MICHAEL TEMPLETON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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