38D2081024 CLIA NUMBER - SAFEWAY PHARMACY #1260

Laboratory Demographics

  • CLIA Code: 38D2081024
  • Facility Name: SAFEWAY PHARMACY #1260
  • Facility Address: 401 S ROOSEVELT DR
    SEASIDE, OR
    ZIP 97138
  • Facility Phone: 503 738-4706
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DERK PENROD
  • NPI Number: 1861421802
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 38D2081024
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1260
Street 401 S ROOSEVELT DR
City SEASIDE
State OR
ZIP 97138
Phone 503 738-4706
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type Pharmacy
Lab Director DERK PENROD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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