38D0996101 CLIA NUMBER - FRED MEYER PHARMACY #240

Laboratory Demographics

  • CLIA Code: 38D0996101
  • Facility Name: FRED MEYER PHARMACY #240
  • Facility Address: 14700 SE MCLOUGHLIN BLVD
    MILWAUKIE, OR
    ZIP 97267
  • Facility Phone: 503 652-4133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. BRIAN M. ZACHER
  • NPI Number: 1548205610
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D0996101
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #240
Street 14700 SE MCLOUGHLIN BLVD
City MILWAUKIE
State OR
ZIP 97267
Phone 503 652-4133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Pharmacy
Lab Director MR. BRIAN M. ZACHER

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