38D0971538 CLIA NUMBER - FRED MEYER PHARMACY #375

Laboratory Demographics

  • CLIA Code: 38D0971538
  • Facility Name: FRED MEYER PHARMACY #375
  • Facility Address: 11565 SW PACIFIC HIGHWAY
    TIGARD, OR
    ZIP 97223
  • Facility Phone: 503 293-7085
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: IAN WOOD
  • NPI Number: 1083081905
  • Taxonomy: 261QP0905X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D0971538
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #375
Street 11565 SW PACIFIC HIGHWAY
City TIGARD
State OR
ZIP 97223
Phone 503 293-7085
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 IAN WOOD

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