05D2059370 CLIA NUMBER - SAFEWAY PHARMACY #1465

Laboratory Demographics

  • CLIA Code: 05D2059370
  • Facility Name: SAFEWAY PHARMACY #1465
  • Facility Address: 5146 STEVEN CREEK BLVD
    SAN JOSE, CA
    ZIP 95129
  • Facility Phone: 408 556-0614
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIMOTHY E. LI
  • NPI Number: 1043256670
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2059370
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1465
Street 5146 STEVEN CREEK BLVD
City SAN JOSE
State CA
ZIP 95129
Phone 408 556-0614
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Pharmacy
Lab Director TIMOTHY E. LI

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