38D1001342 CLIA NUMBER - FRED MEYER PHARMACY #060

Laboratory Demographics

  • CLIA Code: 38D1001342
  • Facility Name: FRED MEYER PHARMACY #060
  • Facility Address: 2200 BASELINE RD
    CORNELIUS, OR
    ZIP 97113
  • Facility Phone: 503 359-3103
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. STEVEN W. BASS
  • NPI Number: 1598216475
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 38D1001342
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #060
Street 2200 BASELINE RD
City CORNELIUS
State OR
ZIP 97113
Phone 503 359-3103
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type Pharmacy
Lab Director MR. STEVEN W. BASS

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