05D2091967 CLIA NUMBER - SAFEWAY PHARMACY #2900

Laboratory Demographics

  • CLIA Code: 05D2091967
  • Facility Name: SAFEWAY PHARMACY #2900
  • Facility Address: 5760 COTTLE RD
    SAN JOSE, CA
    ZIP 95123
  • Facility Phone: 408 362-9623
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WAYNE CHAN
  • NPI Number: 1114320306
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2091967
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2900
Street 5760 COTTLE RD
City SAN JOSE
State CA
ZIP 95123
Phone 408 362-9623
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type Pharmacy
Lab Director WAYNE CHAN

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