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38D0971537 CLIA NUMBER - FRED MEYER PHARMACY #255

Laboratory Demographics

CLIA Number: 38D0971537

Facility Name: FRED MEYER PHARMACY #255

Facility Address:
6850 N LOMBARD
PORTLAND, OR
ZIP 97203
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Facility Phone Number: 503 240-2733

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1811932981

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 38D0971537
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #255
Street 6850 N LOMBARD
City PORTLAND
State OR
ZIP 97203
Phone 503 240-2733
CertificateType 4
CertificateEffectiveDate 3/15/2024
CertificateExpirationDate 3/14/2026
FacilityType Waiver

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