38D2231327 CLIA NUMBER - BEAVERTON PHARMACY

Laboratory Demographics

  • CLIA Code: 38D2231327
  • Facility Name: BEAVERTON PHARMACY
  • Facility Address: 12250 SW CANYON RD
    BEAVERTON, OR
    ZIP 97005
  • Facility Phone: 503 644-2101
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THOMAS WADE IRBY
  • NPI Number: 1639651490
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2231327
LAB Type Pharmacy
Facility Name BEAVERTON PHARMACY
Street 12250 SW CANYON RD
City BEAVERTON
State OR
ZIP 97005
Phone 503 644-2101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2025
Certificate Expiration Date 8/1/2027
Facility Type Pharmacy
Lab Director THOMAS WADE IRBY

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