38D0991451 CLIA NUMBER - FRED MEYER PHARMACY #661

Laboratory Demographics

  • CLIA Code: 38D0991451
  • Facility Name: FRED MEYER PHARMACY #661
  • Facility Address: 22075 NW IMBRIE DRIVE
    HILLSBORO, OR
    ZIP 97124
  • Facility Phone: 503 747-1133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. STEVEN W. BASS
  • NPI Number: 1932135142
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0991451
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #661
Street 22075 NW IMBRIE DRIVE
City HILLSBORO
State OR
ZIP 97124
Phone 503 747-1133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/20/2025
Certificate Expiration Date 9/19/2027
Facility Type Pharmacy
Lab Director MR. STEVEN W. BASS

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