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03D0993730 CLIA NUMBER - SAFEWAY PHARMACY #1662

Laboratory Demographics

CLIA Number: 03D0993730

Facility Name: SAFEWAY PHARMACY #1662

Facility Address:
10641 W OLIVE AVE
PEORIA, AZ
ZIP 85345
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Facility Phone Number: 623 583-6688

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1386676112

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name Field Value
CLIA Number 03D0993730
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1662
Street 10641 W OLIVE AVE
City PEORIA
State AZ
ZIP 85345
Phone 623 583-6688
CertificateType 4
CertificateEffectiveDate 11/21/2023
CertificateExpirationDate 11/20/2025
FacilityType Waiver

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