38D0971558 CLIA NUMBER - FRED MEYER PHARMACY #462

Laboratory Demographics

  • CLIA Code: 38D0971558
  • Facility Name: FRED MEYER PHARMACY #462
  • Facility Address: 51501 COLUMBIA RIVER HWY
    SCAPPOOSE, OR
    ZIP 97056
  • Facility Phone: 503 543-4523
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. STEVEN W. BASS
  • NPI Number: 1619912003
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0971558
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #462
Street 51501 COLUMBIA RIVER HWY
City SCAPPOOSE
State OR
ZIP 97056
Phone 503 543-4523
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. STEVEN W. BASS

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