03D2073038 CLIA NUMBER - SAFEWAY PHARMACY #1637

Laboratory Demographics

  • CLIA Code: 03D2073038
  • Facility Name: SAFEWAY PHARMACY #1637
  • Facility Address: 3622 E SOUTHERN AVE
    MESA, AZ
    ZIP 85206
  • Facility Phone: 480 807-8760
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAREN BLOOM
  • NPI Number: 1639108608
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2073038
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1637
Street 3622 E SOUTHERN AVE
City MESA
State AZ
ZIP 85206
Phone 480 807-8760
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 KAREN BLOOM

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