05D2057743 CLIA NUMBER - SAFEWAY PHARMACY #0788

Laboratory Demographics

  • CLIA Code: 05D2057743
  • Facility Name: SAFEWAY PHARMACY #0788
  • Facility Address: 1 CAMINO ALTO
    MILL VALLEY, CA
    ZIP 94941
  • Facility Phone: 415 388-2701
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AUDREY ECHIBE
  • NPI Number: 1467483271
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2057743
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0788
Street 1 CAMINO ALTO
City MILL VALLEY
State CA
ZIP 94941
Phone 415 388-2701
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 AUDREY ECHIBE

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