05D2086941 CLIA NUMBER - SAFEWAY PHARMACY #1794

Laboratory Demographics

  • CLIA Code: 05D2086941
  • Facility Name: SAFEWAY PHARMACY #1794
  • Facility Address: 1850 PRAIRE CITY RD
    FOLSOM, CA
    ZIP 95630
  • Facility Phone: 916 608-2455
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRAD DEAN, PIC
  • NPI Number: 1942239975
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2086941
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1794
Street 1850 PRAIRE CITY RD
City FOLSOM
State CA
ZIP 95630
Phone 916 608-2455
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Pharmacy
Lab Director BRAD DEAN, PIC

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