38D2273730 CLIA NUMBER - SAFEWAY PHARMACY#1590

Laboratory Demographics

  • CLIA Code: 38D2273730
  • Facility Name: SAFEWAY PHARMACY#1590
  • Facility Address: 455 N COLUMBIA ST
    MILTON FREEWATER, OR
    ZIP 97862
  • Facility Phone: 541 938-3289
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TOM POTTS
  • NPI Number: 1851320899
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2273730
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY#1590
Street 455 N COLUMBIA ST
City MILTON FREEWATER
State OR
ZIP 97862
Phone 541 938-3289
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Pharmacy
Lab Director TOM POTTS

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