50D2254992 CLIA NUMBER - CHINOOK PHARMACY AND VARIETY

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CLIA Record

Field Name Field Value
CLIA Number 50D2254992
LAB Type Pharmacy
Facility Name CHINOOK PHARMACY AND VARIETY
Street 11 S FORKS AVE PO BOX 2136
City FORKS
State WA
ZIP 98331
Phone 360 374-2294
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2022
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director JOSUAH TILUS

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