03D2073024 CLIA NUMBER - SAFEWAY PHARMACY #1515

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Laboratory Demographics

CLIA Number: 03D2073024

Facility Name: SAFEWAY PHARMACY #1515

Facility Address:
810 E GLENDALE AVE
PHOENIX, AZ
ZIP 85020
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Facility Phone Number: 602 331-0440

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1457380495

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	03D2073024
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY #1515
Street	810 E GLENDALE AVE
City	PHOENIX
State	AZ
ZIP	85020
Phone	602 331-0440
CertificateType	4
CertificateEffectiveDate	2/10/2024
CertificateExpirationDate	2/9/2026
FacilityType	Waiver

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