03D2073039 CLIA NUMBER - SAFEWAY PHARMACY #1639

Laboratory Demographics

  • CLIA Code: 03D2073039
  • Facility Name: SAFEWAY PHARMACY #1639
  • Facility Address: 637 W ROUTE 66
    WILLIAMS, AZ
    ZIP 86046
  • Facility Phone: 928 635-5977
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THERESA HAWKS
  • NPI Number: 1114956174
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2073039
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1639
Street 637 W ROUTE 66
City WILLIAMS
State AZ
ZIP 86046
Phone 928 635-5977
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 THERESA HAWKS

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