05D2080925 CLIA NUMBER - SAFEWAY PHARMACY #1266

Laboratory Demographics

  • CLIA Code: 05D2080925
  • Facility Name: SAFEWAY PHARMACY #1266
  • Facility Address: 11290 DONNER PASS RD
    TRUCKEE, CA
    ZIP 96161
  • Facility Phone: 530 582-7952
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: YEN PHUNG PIC
  • NPI Number: 1770529307
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2080925
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1266
Street 11290 DONNER PASS RD
City TRUCKEE
State CA
ZIP 96161
Phone 530 582-7952
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2024
Certificate Expiration Date 7/15/2026
Facility Type Pharmacy
Lab Director YEN PHUNG PIC

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