05D2057735 CLIA NUMBER - SAFEWAY PHARMACY # 1109

Laboratory Demographics

  • CLIA Code: 05D2057735
  • Facility Name: SAFEWAY PHARMACY # 1109
  • Facility Address: 2090 HARBISON DRIVE
    VACAVILLE, CA
    ZIP 95687
  • Facility Phone: 925 452-7279
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTINE LOW-BLUNT
  • NPI Number: 1356370365
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2057735
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY # 1109
Street 2090 HARBISON DRIVE
City VACAVILLE
State CA
ZIP 95687
Phone 925 452-7279
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Pharmacy
Lab Director CHRISTINE LOW-BLUNT

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