38D2081036 CLIA NUMBER - SAFEWAY PHARMACY #1765

Laboratory Demographics

  • CLIA Code: 38D2081036
  • Facility Name: SAFEWAY PHARMACY #1765
  • Facility Address: 5270 SW PHILOMATH BLVD
    CORVALLIS, OR
    ZIP 97333
  • Facility Phone: 541 738-2106
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT WONG
  • NPI Number: 1922037977
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2081036
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1765
Street 5270 SW PHILOMATH BLVD
City CORVALLIS
State OR
ZIP 97333
Phone 541 738-2106
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 ROBERT WONG

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