50D0974174 CLIA NUMBER - FRED MEYER PHARMACY #655

Laboratory Demographics

  • CLIA Code: 50D0974174
  • Facility Name: FRED MEYER PHARMACY #655
  • Facility Address: 1900 SE SEDWICK RD
    PORT ORCHARD, WA
    ZIP 98366
  • Facility Phone: 360 874-7173
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRIS WHITLEY
  • NPI Number: 1992740062
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D0974174
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #655
Street 1900 SE SEDWICK RD
City PORT ORCHARD
State WA
ZIP 98366
Phone 360 874-7173
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2000
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director CHRIS WHITLEY

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