38D0971535 CLIA NUMBER - FRED MEYER PHARMACY #482

Laboratory Demographics

  • CLIA Code: 38D0971535
  • Facility Name: FRED MEYER PHARMACY #482
  • Facility Address: 15995 SW WALKER RD
    BEAVERTON, OR
    ZIP 97006
  • Facility Phone: 503 690-5833
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. STEPHANIE GASTON
  • NPI Number: 1538104922
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0971535
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #482
Street 15995 SW WALKER RD
City BEAVERTON
State OR
ZIP 97006
Phone 503 690-5833
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 MS. STEPHANIE GASTON

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