38D2256393 CLIA NUMBER - SAFEWAY PHARMACY #1478

Laboratory Demographics

  • CLIA Code: 38D2256393
  • Facility Name: SAFEWAY PHARMACY #1478
  • Facility Address: 15570 SW PACIFIC HWY
    TIGARD, OR
    ZIP 97224
  • Facility Phone: 503 598-6009
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIMOTHY PETERSON
  • NPI Number: 1033148077
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2256393
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1478
Street 15570 SW PACIFIC HWY
City TIGARD
State OR
ZIP 97224
Phone 503 598-6009
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2024
Certificate Expiration Date 3/22/2026
Facility Type Pharmacy
Lab Director TIMOTHY PETERSON

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