03D2073044 CLIA NUMBER - SAFEWAY PHARMACY #1732

Laboratory Demographics

  • CLIA Code: 03D2073044
  • Facility Name: SAFEWAY PHARMACY #1732
  • Facility Address: 1449 N ARIZONA BLVD
    COOLIDGE, AZ
    ZIP 85228
  • Facility Phone: 520 723-5552
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREA RUYGROK
  • NPI Number: 1710916762
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2073044
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1732
Street 1449 N ARIZONA BLVD
City COOLIDGE
State AZ
ZIP 85228
Phone 520 723-5552
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Pharmacy
Lab Director ANDREA RUYGROK

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