38D2244756 CLIA NUMBER - PRESCRYPTIVE PHARMACY & PATIENT SERVICES, INC

Laboratory Demographics

  • CLIA Code: 38D2244756
  • Facility Name: PRESCRYPTIVE PHARMACY & PATIENT SERVICES, INC
  • Facility Address: 2127 S HWY 97, STE 150
    REDMOND, OR
    ZIP 97756
  • Facility Phone: 206 413-9475
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN E. RUSSELL
  • NPI Number: 1245978337
  • Taxonomy: 3336M0002X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2244756
LAB Type Pharmacy
Facility Name PRESCRYPTIVE PHARMACY & PATIENT SERVICES, INC
Street 2127 S HWY 97, STE 150
City REDMOND
State OR
ZIP 97756
Phone 206 413-9475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type Pharmacy
Lab Director KEVIN E. RUSSELL

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