50D0980201 CLIA NUMBER - FRED MEYER PHARMACY #459

Laboratory Demographics

  • CLIA Code: 50D0980201
  • Facility Name: FRED MEYER PHARMACY #459
  • Facility Address: 365 RENTON CENTER WAY SW
    RENTON, WA
    ZIP 98055
  • Facility Phone: 425 204-5233
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAHDOKHT GHAHRAMAN
  • NPI Number: 1316973571
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0980201
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #459
Street 365 RENTON CENTER WAY SW
City RENTON
State WA
ZIP 98055
Phone 425 204-5233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2000
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director MAHDOKHT GHAHRAMAN

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