05D2083896 CLIA NUMBER - SAFEWAY PHARMACY #0305

Laboratory Demographics

  • CLIA Code: 05D2083896
  • Facility Name: SAFEWAY PHARMACY #0305
  • Facility Address: 1071 EL CAMINO REAL
    REDWOOD CITY, CA
    ZIP 94063
  • Facility Phone: 650 306-1902
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAGEDA MAHMOUD-THIRUCOTE
  • NPI Number: 1780620393
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2083896
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0305
Street 1071 EL CAMINO REAL
City REDWOOD CITY
State CA
ZIP 94063
Phone 650 306-1902
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2024
Certificate Expiration Date 9/14/2026
Facility Type Pharmacy
Lab Director SAGEDA MAHMOUD-THIRUCOTE

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