05D2062097 CLIA NUMBER - SAFEWAY PHARMACY #0691

Laboratory Demographics

  • CLIA Code: 05D2062097
  • Facility Name: SAFEWAY PHARMACY #0691
  • Facility Address: 1444 SHATTUCK PLACE
    BERKELEY, CA
    ZIP 94709
  • Facility Phone: 510 542-5242
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KESSA GILES
  • NPI Number: 1427308998
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2062097
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0691
Street 1444 SHATTUCK PLACE
City BERKELEY
State CA
ZIP 94709
Phone 510 542-5242
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2025
Certificate Expiration Date 7/9/2027
Facility Type Pharmacy
Lab Director KESSA GILES

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