05D2060745 CLIA NUMBER - SAFEWAY PHARMACY #1661

Laboratory Demographics

  • CLIA Code: 05D2060745
  • Facility Name: SAFEWAY PHARMACY #1661
  • Facility Address: 2001 MCHENRY AVE.
    MODESTO, CA
    ZIP 95350
  • Facility Phone: 209 571-6288
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AHMAD GHOBADI
  • NPI Number: 1306875331
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2060745
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1661
Street 2001 MCHENRY AVE.
City MODESTO
State CA
ZIP 95350
Phone 209 571-6288
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2025
Certificate Expiration Date 6/16/2027
Facility Type Pharmacy
Lab Director AHMAD GHOBADI

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