50D0991308 CLIA NUMBER - FRED MEYER PHARMACY #00659

Laboratory Demographics

CLIA Number: 50D0991308

Facility Name: FRED MEYER PHARMACY #00659

Facility Address:
555 TROSPER RD SW
TUMWATER, WA
ZIP 98501
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Facility Phone Number: 360 753-7933

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1932145471

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	50D0991308
LAB Type	Pharmacy
Facility Name	FRED MEYER PHARMACY #00659
Street	555 TROSPER RD SW
City	TUMWATER
State	WA
ZIP	98501
Phone	360 753-7933
CertificateType	4
CertificateEffectiveDate	9/17/2001
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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This page was last updated on: 4/23/2024