05D1057401 CLIA NUMBER - SAFEWAY PHARMACY #1196

Laboratory Demographics

  • CLIA Code: 05D1057401
  • Facility Name: SAFEWAY PHARMACY #1196
  • Facility Address: 639 SOUTH BERNARDO AVENUE
    SUNNYVALE, CA
    ZIP 94087
  • Facility Phone: 408 732-5902
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SONIA W. SHAH RPH
  • NPI Number: 1447282272
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D1057401
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1196
Street 639 SOUTH BERNARDO AVENUE
City SUNNYVALE
State CA
ZIP 94087
Phone 408 732-5902
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2025
Certificate Expiration Date 5/5/2027
Facility Type Pharmacy
Lab Director SONIA W. SHAH RPH

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