03D2073004 CLIA NUMBER - SAFEWAY PHARMACY #274

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Laboratory Demographics

CLIA Number: 03D2073004

Facility Name: SAFEWAY PHARMACY #274

Facility Address:
450 WHITE SPAR RD
PRESCOTT, AZ
ZIP 86303
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Facility Phone Number: 928 778-3098

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1811926850

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	03D2073004
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY #274
Street	450 WHITE SPAR RD
City	PRESCOTT
State	AZ
ZIP	86303
Phone	928 778-3098
CertificateType	4
CertificateEffectiveDate	3/23/2024
CertificateExpirationDate	3/22/2026
FacilityType	Waiver

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