38D2273744 CLIA NUMBER - SAFEWAY PHARMACY #0406

Laboratory Demographics

  • CLIA Code: 38D2273744
  • Facility Name: SAFEWAY PHARMACY #0406
  • Facility Address: 2836 PACIFIC AVE
    FOREST GROVE, OR
    ZIP 97116
  • Facility Phone: 503 359-8706
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BREKKYN CORCORAN
  • NPI Number: 1770512717
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2273744
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0406
Street 2836 PACIFIC AVE
City FOREST GROVE
State OR
ZIP 97116
Phone 503 359-8706
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 BREKKYN CORCORAN

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