38D0954420 CLIA NUMBER - FRED MEYER PHARMACY #393

Laboratory Demographics

  • CLIA Code: 38D0954420
  • Facility Name: FRED MEYER PHARMACY #393
  • Facility Address: 19200 SW MARTINAZZI AVE
    TUALATIN, OR
    ZIP 97062
  • Facility Phone: (503) 691-4233
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN ZACHER
  • NPI Number: 1831132042
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0954420
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #393
Street 19200 SW MARTINAZZI AVE
City TUALATIN
State OR
ZIP 97062
Phone 5036914233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2026
Certificate Expiration Date 12/31/2027
Facility Type Pharmacy
Lab Director BRIAN ZACHER

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This page was last updated on: 5/18/2026