50D0965840 CLIA NUMBER - FRED MEYER PHARMACY #180

Laboratory Demographics

  • CLIA Code: 50D0965840
  • Facility Name: FRED MEYER PHARMACY #180
  • Facility Address: 4615 196TH ST SW #A
    LYNNWOOD, WA
    ZIP 98036
  • Facility Phone: 425 670-0233
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JULIE HANNA
  • NPI Number: 1568405777
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0965840
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #180
Street 4615 196TH ST SW #A
City LYNNWOOD
State WA
ZIP 98036
Phone 425 670-0233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/1999
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director JULIE HANNA

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