50D1005778 CLIA NUMBER - FRED MEYER PHARMACY #00664

Laboratory Demographics

  • CLIA Code: 50D1005778
  • Facility Name: FRED MEYER PHARMACY #00664
  • Facility Address: 17667 NE 76TH ST
    REDMOND, WA
    ZIP 98052
  • Facility Phone: 425 556-8033
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GUILLERMO CHANG
  • NPI Number: 1841236387
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D1005778
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #00664
Street 17667 NE 76TH ST
City REDMOND
State WA
ZIP 98052
Phone 425 556-8033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2002
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director GUILLERMO CHANG

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