38D2120593 CLIA NUMBER - FRED MEYER PHARMACY #694

Laboratory Demographics

  • CLIA Code: 38D2120593
  • Facility Name: FRED MEYER PHARMACY #694
  • Facility Address: 17005 SE SUNNYSIDE RD
    HAPPY VALLEY, OR
    ZIP 97086
  • Facility Phone: 971 999-6284
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTI DENNING
  • NPI Number: 1629528344
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2120593
LAB Type Pharmacy
Facility Name FRED MEYER PHARMACY #694
Street 17005 SE SUNNYSIDE RD
City HAPPY VALLEY
State OR
ZIP 97086
Phone 971 999-6284
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Pharmacy
Lab Director KRISTI DENNING

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