38D2222362 CLIA NUMBER - WALGREENS #11632

Laboratory Demographics

  • CLIA Code: 38D2222362
  • Facility Name: WALGREENS #11632
  • Facility Address: 2150 FAIRGROUNDS RD NE
    SALEM, OR
    ZIP 97301
  • Facility Phone: 503 428-5107
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIN M. VODKA
  • NPI Number: 1104092303
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2222362
LAB Type Pharmacy
Facility Name WALGREENS #11632
Street 2150 FAIRGROUNDS RD NE
City SALEM
State OR
ZIP 97301
Phone 503 428-5107
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Pharmacy
Lab Director ERIN M. VODKA

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