38D2291368 CLIA NUMBER - WALGREENS 05572

Laboratory Demographics

  • CLIA Code: 38D2291368
  • Facility Name: WALGREENS 05572
  • Facility Address: 2829 N LOMBARD ST
    PORTLAND, OR
    ZIP 97217
  • Facility Phone: 503 737-0317
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID H. UTH
  • NPI Number: 1972518967
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2291368
LAB Type Pharmacy
Facility Name WALGREENS 05572
Street 2829 N LOMBARD ST
City PORTLAND
State OR
ZIP 97217
Phone 503 737-0317
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Pharmacy
Lab Director DAVID H. UTH

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