38D2289446 CLIA NUMBER - WALGREENS 12095

Laboratory Demographics

  • CLIA Code: 38D2289446
  • Facility Name: WALGREENS 12095
  • Facility Address: 1000 N EVERGREEN RD
    WOODBURN, OR
    ZIP 97071
  • Facility Phone: 503 982-8198
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AGAPI SIMIDYON
  • NPI Number: 1568767176
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2289446
LAB Type Pharmacy
Facility Name WALGREENS 12095
Street 1000 N EVERGREEN RD
City WOODBURN
State OR
ZIP 97071
Phone 503 982-8198
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Pharmacy
Lab Director AGAPI SIMIDYON

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