03D2073110 CLIA NUMBER - SAFEWAY PHARMACY #3189

Laboratory Demographics

  • CLIA Code: 03D2073110
  • Facility Name: SAFEWAY PHARMACY #3189
  • Facility Address: 702 W HOPI DR
    HOLBROOK, AZ
    ZIP 86025
  • Facility Phone: 928 524-2661
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHELLEY REDMON
  • NPI Number: 1093744062
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2073110
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #3189
Street 702 W HOPI DR
City HOLBROOK
State AZ
ZIP 86025
Phone 928 524-2661
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2024
Certificate Expiration Date 3/22/2026
Facility Type Pharmacy
Lab Director SHELLEY REDMON

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