05D2204613 CLIA NUMBER - SAFEWAY PHARMACY#1899

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Laboratory Demographics

CLIA Number: 05D2204613

Facility Name: SAFEWAY PHARMACY#1899

Facility Address:
989 SUNRISE AVE
ROSEVILLE, CA
ZIP 95661
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Facility Phone Number: 916 773-4115

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1558392365

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	05D2204613
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY#1899
Street	989 SUNRISE AVE
City	ROSEVILLE
State	CA
ZIP	95661
Phone	916 773-4115
CertificateType	4
CertificateEffectiveDate	12/9/2022
CertificateExpirationDate	12/8/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024