38D2259726 CLIA NUMBER - OREGON CVS PHARMACY, LLC

Laboratory Demographics

  • CLIA Code: 38D2259726
  • Facility Name: OREGON CVS PHARMACY, LLC
  • Facility Address: 12555 NW CORNELL RD
    PORTLAND, OR
    ZIP 97229
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATRICK JUBA
  • NPI Number: 1689327801
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2259726
LAB Type Pharmacy
Facility Name OREGON CVS PHARMACY, LLC
Street 12555 NW CORNELL RD
City PORTLAND
State OR
ZIP 97229
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2024
Certificate Expiration Date 5/9/2026
Facility Type Pharmacy
Lab Director PATRICK JUBA

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