05D2111285 CLIA NUMBER - SAFEWAY PHARMACY #2684

Laboratory Demographics

  • CLIA Code: 05D2111285
  • Facility Name: SAFEWAY PHARMACY #2684
  • Facility Address: 1814 19TH ST
    SACRAMENTO, CA
    ZIP 95811
  • Facility Phone: 916 492-9977
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN M. DURAN PIC
  • NPI Number: 1528097565
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2111285
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2684
Street 1814 19TH ST
City SACRAMENTO
State CA
ZIP 95811
Phone 916 492-9977
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2024
Certificate Expiration Date 4/3/2026
Facility Type Pharmacy
Lab Director RYAN M. DURAN PIC

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