50D0971368 CLIA NUMBER - FRED MEYER BC #00614

Laboratory Demographics

  • CLIA Code: 50D0971368
  • Facility Name: FRED MEYER BC #00614
  • Facility Address: 401 NW 12TH AVE
    BATTLE GROUND, WA
    ZIP 98604
  • Facility Phone: 360 666-5133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK STUHRMAN
  • NPI Number: 1801831979
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0971368
LAB Type Pharmacy
Facility Name FRED MEYER BC #00614
Street 401 NW 12TH AVE
City BATTLE GROUND
State WA
ZIP 98604
Phone 360 666-5133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2000
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director MARK STUHRMAN

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