38D2083553 CLIA NUMBER - SAFEWAY PHARMACY #1601

Laboratory Demographics

  • CLIA Code: 38D2083553
  • Facility Name: SAFEWAY PHARMACY #1601
  • Facility Address: 2490 NE HWY 99 W
    MCMINNVILLE, OR
    ZIP 97128
  • Facility Phone: 503 435-3125
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEVEN J. DEJONG
  • NPI Number: 1114956158
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2083553
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1601
Street 2490 NE HWY 99 W
City MCMINNVILLE
State OR
ZIP 97128
Phone 503 435-3125
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2024
Certificate Expiration Date 9/7/2026
Facility Type Pharmacy
Lab Director STEVEN J. DEJONG

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This page was last updated on: 3/20/2025