13D2011157 CLIA NUMBER - SAFEWAY PHARMACY #0383

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Laboratory Demographics

CLIA Number: 13D2011157

Facility Name: SAFEWAY PHARMACY #0383

Facility Address:
1320 S BLAINE ST
MOSCOW, ID
ZIP 83843
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Facility Phone Number: 208 882-2663

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1073559696

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	13D2011157
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY #0383
Street	1320 S BLAINE ST
City	MOSCOW
State	ID
ZIP	83843
Phone	208 882-2663
CertificateType	4
CertificateEffectiveDate	8/12/2022
CertificateExpirationDate	8/11/2024
FacilityType	Waiver

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