38D2234930 CLIA NUMBER - WALGREENS #10054

Laboratory Demographics

  • CLIA Code: 38D2234930
  • Facility Name: WALGREENS #10054
  • Facility Address: 65 SE GOODFELLOW ST
    ONTARIO, OR
    ZIP 97914
  • Facility Phone: 541 889-6288
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANGELA D. MARTIN
  • NPI Number: 1689862708
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2234930
LAB Type Pharmacy
Facility Name WALGREENS #10054
Street 65 SE GOODFELLOW ST
City ONTARIO
State OR
ZIP 97914
Phone 541 889-6288
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2025
Certificate Expiration Date 9/2/2027
Facility Type Pharmacy
Lab Director ANGELA D. MARTIN

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