38D2274249 CLIA NUMBER - SAFEWAY PHARMACY #0430

Laboratory Demographics

  • CLIA Code: 38D2274249
  • Facility Name: SAFEWAY PHARMACY #0430
  • Facility Address: 1455 NE DIVISION ST
    GRESHAM, OR
    ZIP 97030
  • Facility Phone: 503 492-7279
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAI TRAM HEY
  • NPI Number: 1538198569
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2274249
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0430
Street 1455 NE DIVISION ST
City GRESHAM
State OR
ZIP 97030
Phone 503 492-7279
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Pharmacy
Lab Director MAI TRAM HEY

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