03D2073059 CLIA NUMBER - SAFEWAY PHARMACY #2648

Laboratory Demographics

  • CLIA Code: 03D2073059
  • Facility Name: SAFEWAY PHARMACY #2648
  • Facility Address: 2125 W HIGHWAY 70
    THATCHER, AZ
    ZIP 85552
  • Facility Phone: 928 428-7244
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PRISCA BOSIRE-HORGAN
  • NPI Number: 1053340026
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2073059
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2648
Street 2125 W HIGHWAY 70
City THATCHER
State AZ
ZIP 85552
Phone 928 428-7244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2024
Certificate Expiration Date 3/7/2026
Facility Type Pharmacy
Lab Director PRISCA BOSIRE-HORGAN

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