05D2058286 CLIA NUMBER - SAFEWAY PHARMACY #1990

Laboratory Demographics

  • CLIA Code: 05D2058286
  • Facility Name: SAFEWAY PHARMACY #1990
  • Facility Address: 3970 RIVERMARK PLAZA
    SANTA CLARA, CA
    ZIP 95053
  • Facility Phone: 408 855-0985
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SONAL CHRISTIE
  • NPI Number: 1982633939
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2058286
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1990
Street 3970 RIVERMARK PLAZA
City SANTA CLARA
State CA
ZIP 95053
Phone 408 855-0985
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Pharmacy
Lab Director SONAL CHRISTIE

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