03D2073002 CLIA NUMBER - SAFEWAY PHARMACY #0272

Laboratory Demographics

  • CLIA Code: 03D2073002
  • Facility Name: SAFEWAY PHARMACY #0272
  • Facility Address: 650 N BISBEE AVE
    WILLCOX, AZ
    ZIP 85643
  • Facility Phone: 520 384-4612
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN GERTH
  • NPI Number: 1184653131
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2073002
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0272
Street 650 N BISBEE AVE
City WILLCOX
State AZ
ZIP 85643
Phone 520 384-4612
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Pharmacy
Lab Director RYAN GERTH

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