05D2064268 CLIA NUMBER - SAFEWAY PHARMACY #978

Laboratory Demographics

  • CLIA Code: 05D2064268
  • Facility Name: SAFEWAY PHARMACY #978
  • Facility Address: 660 S MAIN ST
    FORT BRAGG, CA
    ZIP 95437
  • Facility Phone: 707 964-4058
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK YAP
  • NPI Number: 1619913498
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2064268
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #978
Street 660 S MAIN ST
City FORT BRAGG
State CA
ZIP 95437
Phone 707 964-4058
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Pharmacy
Lab Director MARK YAP

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