38D2292278 CLIA NUMBER - WALGREENS 04229

Laboratory Demographics

CLIA Number: 38D2292278

Facility Name: WALGREENS 04229

Facility Address:
1992 LANCASTER DR NE
SALEM, OR
ZIP 97305
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Facility Phone Number: 503 362-4845

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1780699769

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	38D2292278
LAB Type	Pharmacy
Facility Name	WALGREENS 04229
Street	1992 LANCASTER DR NE
City	SALEM
State	OR
ZIP	97305
Phone	503 362-4845
CertificateType	4
CertificateEffectiveDate	10/24/2023
CertificateExpirationDate	10/23/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024