38D2083548 CLIA NUMBER - SAFEWAY PHARMACY #4404

Laboratory Demographics

  • CLIA Code: 38D2083548
  • Facility Name: SAFEWAY PHARMACY #4404
  • Facility Address: 138 W ELLENDALE AVE
    DALLAS, OR
    ZIP 97338
  • Facility Phone: (503) 831-6006
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GINA LEE
  • NPI Number: 1053357822
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2083548
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #4404
Street 138 W ELLENDALE AVE
City DALLAS
State OR
ZIP 97338
Phone 5038316006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2024
Certificate Expiration Date 9/12/2026
Facility Type Pharmacy
Lab Director GINA LEE

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This page was last updated on: 5/18/2026