03D2063890 CLIA NUMBER - SAFEWAY PHARMACY #2028

Laboratory Demographics

  • CLIA Code: 03D2063890
  • Facility Name: SAFEWAY PHARMACY #2028
  • Facility Address: 1201 S PLAZA WAY
    FLAGSTAFF, AZ
    ZIP 86001
  • Facility Phone: 928 556-9170
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HEATHER COOPER
  • NPI Number: 1629007679
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2063890
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2028
Street 1201 S PLAZA WAY
City FLAGSTAFF
State AZ
ZIP 86001
Phone 928 556-9170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2025
Certificate Expiration Date 8/8/2027
Facility Type Pharmacy
Lab Director HEATHER COOPER

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