38D2224452 CLIA NUMBER - WALGREENS #09650

Laboratory Demographics

  • CLIA Code: 38D2224452
  • Facility Name: WALGREENS #09650
  • Facility Address: 699 WALLACE RD NW
    SALEM, OR
    ZIP 97304
  • Facility Phone: 503 428-5073
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAIN F. HUDSON
  • NPI Number: 1336298181
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2224452
LAB Type Pharmacy
Facility Name WALGREENS #09650
Street 699 WALLACE RD NW
City SALEM
State OR
ZIP 97304
Phone 503 428-5073
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Pharmacy
Lab Director RAIN F. HUDSON

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