38D0971555 CLIA NUMBER - FRED MEYER PHARMACY #663

Laboratory Demographics

  • CLIA Code: 38D0971555
  • Facility Name: FRED MEYER PHARMACY #663
  • Facility Address: 16625 362ND AVE
    SANDY, OR
    ZIP 97055
  • Facility Phone: 503 668-2363
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. SEAN L. TOYOOKA
  • NPI Number: 1043256589
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0971555
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #663
Street 16625 362ND AVE
City SANDY
State OR
ZIP 97055
Phone 503 668-2363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2024
Certificate Expiration Date 3/15/2026
Facility Type Pharmacy
Lab Director MR. SEAN L. TOYOOKA

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