38D2081035 CLIA NUMBER - SAFEWAY PHARMACY #1751

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Laboratory Demographics

CLIA Number: 38D2081035

Facility Name: SAFEWAY PHARMACY #1751

Facility Address:
1525 W MAIN ST
MOLALLA, OR
ZIP 97038
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Facility Phone Number: 503 829-4855

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1740219799

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	38D2081035
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY #1751
Street	1525 W MAIN ST
City	MOLALLA
State	OR
ZIP	97038
Phone	503 829-4855
CertificateType	4
CertificateEffectiveDate	7/17/2022
CertificateExpirationDate	7/16/2024
FacilityType	Waiver

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