38D2289925 CLIA NUMBER - WALGREENS 04495

Laboratory Demographics

  • CLIA Code: 38D2289925
  • Facility Name: WALGREENS 04495
  • Facility Address: 2103 W BURNSIDE ST
    PORTLAND, OR
    ZIP 97210
  • Facility Phone: 503 295-6480
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEREME M. YUHAS
  • NPI Number: 1316952393
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2289925
LAB Type Pharmacy
Facility Name WALGREENS 04495
Street 2103 W BURNSIDE ST
City PORTLAND
State OR
ZIP 97210
Phone 503 295-6480
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Pharmacy
Lab Director JEREME M. YUHAS

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