05D2092127 CLIA NUMBER - SAFEWAY PHARMACY #1917

Laboratory Demographics

  • CLIA Code: 05D2092127
  • Facility Name: SAFEWAY PHARMACY #1917
  • Facility Address: 14840 HWY 4
    DISCOVERY BAY, CA
    ZIP 94505
  • Facility Phone: 925 626-6011
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUDHA BUNETI
  • NPI Number: 1609805654
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2092127
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1917
Street 14840 HWY 4
City DISCOVERY BAY
State CA
ZIP 94505
Phone 925 626-6011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2025
Certificate Expiration Date 2/25/2027
Facility Type Pharmacy
Lab Director SUDHA BUNETI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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