38D1080623 CLIA NUMBER - SAFEWAY PHARMACY #0536

Laboratory Demographics

  • CLIA Code: 38D1080623
  • Facility Name: SAFEWAY PHARMACY #0536
  • Facility Address: 25691 SE STARK ST
    TROUTDALE, OR
    ZIP 97060
  • Facility Phone: 503 667-9003
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CATHERINE M. NGO
  • NPI Number: 1669428215
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D1080623
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0536
Street 25691 SE STARK ST
City TROUTDALE
State OR
ZIP 97060
Phone 503 667-9003
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Pharmacy
Lab Director CATHERINE M. NGO

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