05D2058069 CLIA NUMBER - SAFEWAY PHARMACY #0933

Laboratory Demographics

  • CLIA Code: 05D2058069
  • Facility Name: SAFEWAY PHARMACY #0933
  • Facility Address: 406 N MAIN ST
    SEBASTOPOL, CA
    ZIP 95472
  • Facility Phone: 707 823-1037
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALVIN VASQUEZ
  • NPI Number: 1952347585
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2058069
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0933
Street 406 N MAIN ST
City SEBASTOPOL
State CA
ZIP 95472
Phone 707 823-1037
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 ALVIN VASQUEZ

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This page was last updated on: 6/4/2025