05D2091905 CLIA NUMBER - SAFEWAY PHARMACY # 2940

Laboratory Demographics

  • CLIA Code: 05D2091905
  • Facility Name: SAFEWAY PHARMACY # 2940
  • Facility Address: 11450 SAN PABLO AVE
    EL CERRITO, CA
    ZIP 94530
  • Facility Phone: 510 233-8405
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTINE L. LIBERATO-LIM, PIC
  • NPI Number: 1447289483
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2091905
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY # 2940
Street 11450 SAN PABLO AVE
City EL CERRITO
State CA
ZIP 94530
Phone 510 233-8405
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/20/2025
Certificate Expiration Date 2/19/2027
Facility Type Pharmacy
Lab Director JUSTINE L. LIBERATO-LIM, PIC

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This page was last updated on: 6/4/2025