50D0976777 CLIA NUMBER - FRED MEYER PHARMACY #351

Laboratory Demographics

  • CLIA Code: 50D0976777
  • Facility Name: FRED MEYER PHARMACY #351
  • Facility Address: 15609 EAST SPRAGUE
    VERADALE, WA
    ZIP 99037
  • Facility Phone: 509 921-5383
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GEN CHAN
  • NPI Number: 1851337398
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0976777
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #351
Street 15609 EAST SPRAGUE
City VERADALE
State WA
ZIP 99037
Phone 509 921-5383
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2000
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director GEN CHAN

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