03D2073089 CLIA NUMBER - SAFEWAY PHARMACY #2699

Laboratory Demographics

  • CLIA Code: 03D2073089
  • Facility Name: SAFEWAY PHARMACY #2699
  • Facility Address: 13828 W WADDELL RD
    SURPRISE, AZ
    ZIP 85379
  • Facility Phone: 623 476-1811
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIAJANA GONZALES
  • NPI Number: 1871522847
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2073089
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2699
Street 13828 W WADDELL RD
City SURPRISE
State AZ
ZIP 85379
Phone 623 476-1811
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Pharmacy
Lab Director TIAJANA GONZALES

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