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38D0874482 CLIA NUMBER - SAMARITAN EVERGREEN HOSPICE

Laboratory Demographics

CLIA Number: 38D0874482

Facility Name: SAMARITAN EVERGREEN HOSPICE

Facility Address:
4600 EVERGREEN PLACE SE
ALBANY, OR
ZIP 97322
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Facility Phone Number: 541 812-4662

Facility Type: Hospice

Certificate Type: Waiver
NPI Number: 1316302672

Taxonomy: 183500000X - Pharmacist
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

CLIA Record

Field Name Field Value
CLIA Number 38D0874482
LAB Type Hospice
Facility Name SAMARITAN EVERGREEN HOSPICE
Street 4600 EVERGREEN PLACE SE
City ALBANY
State OR
ZIP 97322
Phone 541 812-4662
CertificateType 4
CertificateEffectiveDate 1/1/2024
CertificateExpirationDate 12/31/2025
FacilityType Waiver

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