38D1051701 CLIA NUMBER - FRED MEYER PHARMACY #153

Laboratory Demographics

  • CLIA Code: 38D1051701
  • Facility Name: FRED MEYER PHARMACY #153
  • Facility Address: 8955 SE 82ND AVE
    PORTLAND, OR
    ZIP 97266
  • Facility Phone: 503 788-2033
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: IAN WOOD
  • NPI Number: 1356386742
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D1051701
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #153
Street 8955 SE 82ND AVE
City PORTLAND
State OR
ZIP 97266
Phone 503 788-2033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2024
Certificate Expiration Date 3/7/2026
Facility Type Pharmacy
Lab Director IAN WOOD

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