05D2084234 CLIA NUMBER - SAFEWAY PHARMACY #2621

Laboratory Demographics

  • CLIA Code: 05D2084234
  • Facility Name: SAFEWAY PHARMACY #2621
  • Facility Address: 3110 BALFOUR AVE
    BRENTWOOD, CA
    ZIP 94513
  • Facility Phone: 925 626-6030
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHELLE K. CHANG
  • NPI Number: 1265463079
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2084234
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2621
Street 3110 BALFOUR AVE
City BRENTWOOD
State CA
ZIP 94513
Phone 925 626-6030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2024
Certificate Expiration Date 9/18/2026
Facility Type Pharmacy
Lab Director MICHELLE K. CHANG

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