38D2274196 CLIA NUMBER - SAFEWAY PHARMACY #1123

Laboratory Demographics

  • CLIA Code: 38D2274196
  • Facility Name: SAFEWAY PHARMACY #1123
  • Facility Address: 2249 CASCADE AVE
    HOOD RIVER, OR
    ZIP 97031
  • Facility Phone: 541 386-8374
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEREK ENGEBRETSON
  • NPI Number: 1194754143
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2274196
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1123
Street 2249 CASCADE AVE
City HOOD RIVER
State OR
ZIP 97031
Phone 541 386-8374
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/28/2024
Certificate Expiration Date 12/27/2026
Facility Type Pharmacy
Lab Director DEREK ENGEBRETSON

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This page was last updated on: 6/4/2025