05D2289179 CLIA NUMBER - SAFEWAY PHARMACY # 3013

Laboratory Demographics

  • CLIA Code: 05D2289179
  • Facility Name: SAFEWAY PHARMACY # 3013
  • Facility Address: 3680 CROCKER DRIVE SUITE 100
    SACRAMENTO, CA
    ZIP 95818
  • Facility Phone: 279 399-9270
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VAN TANG
  • NPI Number: 1467928200
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2289179
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY # 3013
Street 3680 CROCKER DRIVE SUITE 100
City SACRAMENTO
State CA
ZIP 95818
Phone 279 399-9270
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2025
Certificate Expiration Date 9/5/2027
Facility Type Pharmacy
Lab Director VAN TANG

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