38D2289958 CLIA NUMBER - WALGREENS 06140

Laboratory Demographics

  • CLIA Code: 38D2289958
  • Facility Name: WALGREENS 06140
  • Facility Address: 1620 NE GRAND AVE
    PORTLAND, OR
    ZIP 97232
  • Facility Phone: 503 493-2715
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAI T. VO
  • NPI Number: 1326053315
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2289958
LAB Type Pharmacy
Facility Name WALGREENS 06140
Street 1620 NE GRAND AVE
City PORTLAND
State OR
ZIP 97232
Phone 503 493-2715
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 MAI T. VO

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