03D2040391 CLIA NUMBER - SAFEWAY PHARMACY #2644

Laboratory Demographics

  • CLIA Code: 03D2040391
  • Facility Name: SAFEWAY PHARMACY #2644
  • Facility Address: 1855 N POWER RD
    MESA, AZ
    ZIP 85205
  • Facility Phone: 480 281-2990
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEREK KERN
  • NPI Number: 1144259110
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2040391
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2644
Street 1855 N POWER RD
City MESA
State AZ
ZIP 85205
Phone 480 281-2990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Pharmacy
Lab Director DEREK KERN

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