05D2060260 CLIA NUMBER - SAFEWAY PHARMACY #2718

Laboratory Demographics

  • CLIA Code: 05D2060260
  • Facility Name: SAFEWAY PHARMACY #2718
  • Facility Address: 800 REDWOOD HWY FRONTAGE RD #110
    MILL VALLEY, CA
    ZIP 94941
  • Facility Phone: 415 360-9020
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUZANNE L. IACOVELLI
  • NPI Number: 1790711570
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2060260
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2718
Street 800 REDWOOD HWY FRONTAGE RD #110
City MILL VALLEY
State CA
ZIP 94941
Phone 415 360-9020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2025
Certificate Expiration Date 6/9/2027
Facility Type Pharmacy
Lab Director SUZANNE L. IACOVELLI

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