38D2289931 CLIA NUMBER - WALGREENS 06426

Laboratory Demographics

  • CLIA Code: 38D2289931
  • Facility Name: WALGREENS 06426
  • Facility Address: 12335 NE GLISAN ST
    PORTLAND, OR
    ZIP 97230
  • Facility Phone: 503 256-2932
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMANTHA E. VOSIKA
  • NPI Number: 1104833029
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2289931
LAB Type Pharmacy
Facility Name WALGREENS 06426
Street 12335 NE GLISAN ST
City PORTLAND
State OR
ZIP 97230
Phone 503 256-2932
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 SAMANTHA E. VOSIKA

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