03D2073022 CLIA NUMBER - SAFEWAY PHARMACY #1474

Home > CLIA Lookup > 03D2073022

Laboratory Demographics

CLIA Number: 03D2073022

Facility Name: SAFEWAY PHARMACY #1474

Facility Address:
4823 S HIGHWAY 95
FORT MOHAVE, AZ
ZIP 86426
Get Directions

Facility Phone Number: 928 704-4443

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1083643035

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	03D2073022
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY #1474
Street	4823 S HIGHWAY 95
City	FORT MOHAVE
State	AZ
ZIP	86426
Phone	928 704-4443
CertificateType	4
CertificateEffectiveDate	2/23/2024
CertificateExpirationDate	2/22/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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