05D2059187 CLIA NUMBER - SAFEWAY PHARMACY #0951

Laboratory Demographics

  • CLIA Code: 05D2059187
  • Facility Name: SAFEWAY PHARMACY #0951
  • Facility Address: 867 ISLAND DR
    ALAMEDA, CA
    ZIP 94502
  • Facility Phone: 510 747-1647
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN D. FONG
  • NPI Number: 1619906633
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2059187
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0951
Street 867 ISLAND DR
City ALAMEDA
State CA
ZIP 94502
Phone 510 747-1647
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2023
Certificate Expiration Date 5/19/2025
Facility Type Pharmacy
Lab Director BRIAN D. FONG

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This page was last updated on: 3/20/2025