05D2059776 CLIA NUMBER - SAFEWAY PHARMACY #1879

Laboratory Demographics

  • CLIA Code: 05D2059776
  • Facility Name: SAFEWAY PHARMACY #1879
  • Facility Address: 555 E CALAVERAS BLVD
    MILPITAS, CA
    ZIP 95035
  • Facility Phone: 408 262-9855
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NGOC NGO-NGUYEN
  • NPI Number: 1982823282
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2059776
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1879
Street 555 E CALAVERAS BLVD
City MILPITAS
State CA
ZIP 95035
Phone 408 262-9855
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Pharmacy
Lab Director NGOC NGO-NGUYEN

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