50D1015767 CLIA NUMBER - FRED MEYER PHARMACY #00604

Laboratory Demographics

  • CLIA Code: 50D1015767
  • Facility Name: FRED MEYER PHARMACY #00604
  • Facility Address: 22303 MOUNTAIN HWY EAST
    SPANAWAY, WA
    ZIP 98387
  • Facility Phone: 253 875-4033
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH CANTO
  • NPI Number: 1679518013
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D1015767
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #00604
Street 22303 MOUNTAIN HWY EAST
City SPANAWAY
State WA
ZIP 98387
Phone 253 875-4033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2003
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director JOSEPH CANTO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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