03D2063901 CLIA NUMBER - SAFEWAY PHARMACY #1511

Laboratory Demographics

  • CLIA Code: 03D2063901
  • Facility Name: SAFEWAY PHARMACY #1511
  • Facility Address: 14175 W INDIAN SCHOOL RD
    GOODYEAR, AZ
    ZIP 85395
  • Facility Phone: 623 935-3531
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW HINES
  • NPI Number: 1437188489
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2063901
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1511
Street 14175 W INDIAN SCHOOL RD
City GOODYEAR
State AZ
ZIP 85395
Phone 623 935-3531
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 MATTHEW HINES

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