50D0990693 CLIA NUMBER - FRED MEYER PHARMACY #00657

Laboratory Demographics

  • CLIA Code: 50D0990693
  • Facility Name: FRED MEYER PHARMACY #00657
  • Facility Address: 400 SOUTH THOR ST
    SPOKANE, WA
    ZIP 99202
  • Facility Phone: 509 532-4033
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER LESSIAK
  • NPI Number: 1023054566
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0990693
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #00657
Street 400 SOUTH THOR ST
City SPOKANE
State WA
ZIP 99202
Phone 509 532-4033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2001
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director JENNIFER LESSIAK

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