03D2073024 CLIA NUMBER - SAFEWAY PHARMACY #1515

Laboratory Demographics

  • CLIA Code: 03D2073024
  • Facility Name: SAFEWAY PHARMACY #1515
  • Facility Address: 810 E GLENDALE AVE
    PHOENIX, AZ
    ZIP 85020
  • Facility Phone: 602 331-0440
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN COOK
  • NPI Number: 1457380495
  • Taxonomy: 3336C0003X - Pharmacy

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Pharmacy
Lab Director RYAN COOK

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