38D2291373 CLIA NUMBER - WALGREENS #3890

Laboratory Demographics

  • CLIA Code: 38D2291373
  • Facility Name: WALGREENS #3890
  • Facility Address: 940 SE CESAR E CHAVEZ BLVD
    PORTLAND, OR
    ZIP 97214
  • Facility Phone: 503 238-6053
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATRICK MCMULLEN
  • NPI Number: 1417962499
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2291373
LAB Type Pharmacy
Facility Name WALGREENS #3890
Street 940 SE CESAR E CHAVEZ BLVD
City PORTLAND
State OR
ZIP 97214
Phone 503 238-6053
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 PATRICK MCMULLEN

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