38D2182590 CLIA NUMBER - WALGREENS #09353

Laboratory Demographics

  • CLIA Code: 38D2182590
  • Facility Name: WALGREENS #09353
  • Facility Address: 115 N 20TH AVE
    CORNELIUS, OR
    ZIP 97113
  • Facility Phone: 503 357-0762
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SEAN M. BALLARD
  • NPI Number: 1770598765
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2182590
LAB Type Pharmacy
Facility Name WALGREENS #09353
Street 115 N 20TH AVE
City CORNELIUS
State OR
ZIP 97113
Phone 503 357-0762
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2024
Certificate Expiration Date 4/22/2026
Facility Type Pharmacy
Lab Director SEAN M. BALLARD

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