05D2091982 CLIA NUMBER - SAFEWAY PHARMACY # 1618

Laboratory Demographics

  • CLIA Code: 05D2091982
  • Facility Name: SAFEWAY PHARMACY # 1618
  • Facility Address: 3380 COACH LN
    CAMERON PARK, CA
    ZIP 95682
  • Facility Phone: 530 676-6938
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ABDUL AHMAD
  • NPI Number: 1558307165
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2091982
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY # 1618
Street 3380 COACH LN
City CAMERON PARK
State CA
ZIP 95682
Phone 530 676-6938
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2025
Certificate Expiration Date 2/23/2027
Facility Type Pharmacy
Lab Director ABDUL AHMAD

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