05D2062672 CLIA NUMBER - SAFEWAY PHARMACY #1825

Laboratory Demographics

  • CLIA Code: 05D2062672
  • Facility Name: SAFEWAY PHARMACY #1825
  • Facility Address: 6498 PONY EXPRESS TRAIL
    POLLOCK PINES, CA
    ZIP 95726
  • Facility Phone: 530 647-7449
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATRICIA BUCHANAN
  • NPI Number: 1235168279
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2062672
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1825
Street 6498 PONY EXPRESS TRAIL
City POLLOCK PINES
State CA
ZIP 95726
Phone 530 647-7449
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/19/2025
Certificate Expiration Date 7/18/2027
Facility Type Pharmacy
Lab Director PATRICIA BUCHANAN

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