03D2110795 CLIA NUMBER - SAFEWAY PHARMACY #3322

Laboratory Demographics

  • CLIA Code: 03D2110795
  • Facility Name: SAFEWAY PHARMACY #3322
  • Facility Address: 10380 E BROADWAY BLVD
    TUCSON, AZ
    ZIP 85748
  • Facility Phone: 520 918-7221
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TERRENCE R. JACKSON
  • NPI Number: 1770948556
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2110795
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #3322
Street 10380 E BROADWAY BLVD
City TUCSON
State AZ
ZIP 85748
Phone 520 918-7221
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 TERRENCE R. JACKSON

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