05D2079746 CLIA NUMBER - SAFEWAY PHARMACY # 0316

Laboratory Demographics

  • CLIA Code: 05D2079746
  • Facility Name: SAFEWAY PHARMACY # 0316
  • Facility Address: 179 BRANHAM LANE
    SAN JOSE, CA
    ZIP 95136
  • Facility Phone: 408 227-5911
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAITRAM T. NGUYEN PIC
  • NPI Number: 1881623833
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2079746
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY # 0316
Street 179 BRANHAM LANE
City SAN JOSE
State CA
ZIP 95136
Phone 408 227-5911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2024
Certificate Expiration Date 4/27/2026
Facility Type Pharmacy
Lab Director MAITRAM T. NGUYEN PIC

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