05D2080546 CLIA NUMBER - SAFEWAY PHARMACY #1483

Laboratory Demographics

  • CLIA Code: 05D2080546
  • Facility Name: SAFEWAY PHARMACY #1483
  • Facility Address: 1530 HAMILTON AVENUE
    SAN JOSE, CA
    ZIP 95125
  • Facility Phone: 408 264-5391
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SE NE HUANG
  • NPI Number: 1174569719
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2080546
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1483
Street 1530 HAMILTON AVENUE
City SAN JOSE
State CA
ZIP 95125
Phone 408 264-5391
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type Pharmacy
Lab Director SE NE HUANG

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This page was last updated on: 6/4/2025