05D2269870 CLIA NUMBER - SAFEWAY PHARMACY #2712

Laboratory Demographics

  • CLIA Code: 05D2269870
  • Facility Name: SAFEWAY PHARMACY #2712
  • Facility Address: 11050 BOLLINGER CANYON RD
    SAN RAMON, CA
    ZIP 94582
  • Facility Phone: 925 359-2005
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHANTHI PADALA
  • NPI Number: 1407056872
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2269870
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2712
Street 11050 BOLLINGER CANYON RD
City SAN RAMON
State CA
ZIP 94582
Phone 925 359-2005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Pharmacy
Lab Director SHANTHI PADALA

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