38D1103971 CLIA NUMBER - OREGON STATE UNIVERSITY COLLEGE OF PHARMACY

Laboratory Demographics

CLIA Number: 38D1103971

Facility Name: OREGON STATE UNIVERSITY COLLEGE OF PHARMACY

Facility Address:
1601 SW JEFFERSON - 203 PHARMACY BLDG
CORVALLIS, OR
ZIP 97331
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Facility Phone Number: 541 737-5791

Facility Type: Health Fair

Certificate Type: Waiver

NPI Number: 1316048531

Taxonomy: 261QS1000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	38D1103971
LAB Type	Health Fair
Facility Name	OREGON STATE UNIVERSITY COLLEGE OF PHARMACY
Street	1601 SW JEFFERSON - 203 PHARMACY BLDG
City	CORVALLIS
State	OR
ZIP	97331
Phone	541 737-5791
CertificateType	4
CertificateEffectiveDate	8/21/2023
CertificateExpirationDate	8/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024