05D2267478 CLIA NUMBER - SAFEWAY PHARMACY #0640

Laboratory Demographics

  • CLIA Code: 05D2267478
  • Facility Name: SAFEWAY PHARMACY #0640
  • Facility Address: 16 RANCHO DEL MAR
    APTOS, CA
    ZIP 95003
  • Facility Phone: 831 661-4861
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACQUELYN HERNANDEZ
  • NPI Number: 1467498071
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2267478
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0640
Street 16 RANCHO DEL MAR
City APTOS
State CA
ZIP 95003
Phone 831 661-4861
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Pharmacy
Lab Director JACQUELYN HERNANDEZ

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This page was last updated on: 6/4/2025