03D2073058 CLIA NUMBER - SAFEWAY PHARMACY #2618

Laboratory Demographics

  • CLIA Code: 03D2073058
  • Facility Name: SAFEWAY PHARMACY #2618
  • Facility Address: 440 N ESTRELLA PKWY
    GOODYEAR, AZ
    ZIP 85338
  • Facility Phone: 623 476-1720
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: COURTNEY MONTENEGRO
  • NPI Number: 1629000450
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2073058
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2618
Street 440 N ESTRELLA PKWY
City GOODYEAR
State AZ
ZIP 85338
Phone 623 476-1720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Pharmacy
Lab Director COURTNEY MONTENEGRO

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