50D2254095 CLIA NUMBER - K-C PHARMACY

Laboratory Demographics

  • CLIA Code: 50D2254095
  • Facility Name: K-C PHARMACY
  • Facility Address: GOLDENDALE PHARMACY ADDRESS: PUBLIC MAIL
    GOLDENDALE, WA
    ZIP 98620
  • Facility Phone: 509 773-4344
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELINE EIDE
  • NPI Number: 1689328312
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2254095
LAB Type Pharmacy
Facility Name K-C PHARMACY
Street GOLDENDALE PHARMACY ADDRESS: PUBLIC MAIL
City GOLDENDALE
State WA
ZIP 98620
Phone 509 773-4344
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2022
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director JACQUELINE EIDE

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