05D2058056 CLIA NUMBER - SAFEWAY PHARMACY #1127

Laboratory Demographics

  • CLIA Code: 05D2058056
  • Facility Name: SAFEWAY PHARMACY #1127
  • Facility Address: 2401 WATERMAN BLVD
    FAIRFIELD, CA
    ZIP 94533
  • Facility Phone: 707 427-5642
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIT I. CHEANG RPH
  • NPI Number: 1235175829
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2058056
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1127
Street 2401 WATERMAN BLVD
City FAIRFIELD
State CA
ZIP 94533
Phone 707 427-5642
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Pharmacy
Lab Director KIT I. CHEANG RPH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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