38D2274197 CLIA NUMBER - SAFEWAY PHARMACY #0521

Laboratory Demographics

  • CLIA Code: 38D2274197
  • Facility Name: SAFEWAY PHARMACY #0521
  • Facility Address: 20151 SE HIGHWAY 212
    BORING, OR
    ZIP 97009
  • Facility Phone: 503 658-7005
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL BREEDLOVE
  • NPI Number: 1457380487
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2274197
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0521
Street 20151 SE HIGHWAY 212
City BORING
State OR
ZIP 97009
Phone 503 658-7005
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 DANIEL BREEDLOVE

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