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38D2289896 CLIA NUMBER - WALGREENS 01100

Laboratory Demographics

CLIA Number: 38D2289896

Facility Name: WALGREENS 01100

Facility Address:
9159 SE 82ND AVE
HAPPY VALLEY, OR
ZIP 97086
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Facility Phone Number: 503 771-1386

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1831106715

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 38D2289896
LAB Type Pharmacy
Facility Name WALGREENS 01100
Street 9159 SE 82ND AVE
City HAPPY VALLEY
State OR
ZIP 97086
Phone 503 771-1386
CertificateType 4
CertificateEffectiveDate 9/18/2023
CertificateExpirationDate 9/17/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024