05D2085159 CLIA NUMBER - SAFEWAY PHARMACY #1197

Laboratory Demographics

  • CLIA Code: 05D2085159
  • Facility Name: SAFEWAY PHARMACY #1197
  • Facility Address: 1790 DECOTO RD
    UNION CITY, CA
    ZIP 94587
  • Facility Phone: 510 429-9093
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AUSTIN NGUYEN
  • NPI Number: 1952347544
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2085159
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1197
Street 1790 DECOTO RD
City UNION CITY
State CA
ZIP 94587
Phone 510 429-9093
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2024
Certificate Expiration Date 10/7/2026
Facility Type Pharmacy
Lab Director AUSTIN NGUYEN

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