38D0971534 CLIA NUMBER - FRED MEYER PHARMACY #035

Laboratory Demographics

  • CLIA Code: 38D0971534
  • Facility Name: FRED MEYER PHARMACY #035
  • Facility Address: 11425 SW BEAVERTON HILLSDALE HWY
    BEAVERTON, OR
    ZIP 97005
  • Facility Phone: 503 526-1833
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE GASTON
  • NPI Number: 1639114705
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0971534
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #035
Street 11425 SW BEAVERTON HILLSDALE HWY
City BEAVERTON
State OR
ZIP 97005
Phone 503 526-1833
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Pharmacy
Lab Director STEPHANIE GASTON

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