13D2082229 CLIA NUMBER - SAFEWAY PHARMACY #1470

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Laboratory Demographics

CLIA Number: 13D2082229

Facility Name: SAFEWAY PHARMACY #1470

Facility Address:
121 W NEIDER AVE
COEUR D ALENE, ID
ZIP 83815
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Facility Phone Number: 208 765-4410

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1164468781

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	13D2082229
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY #1470
Street	121 W NEIDER AVE
City	COEUR D ALENE
State	ID
ZIP	83815
Phone	208 765-4410
CertificateType	4
CertificateEffectiveDate	8/11/2022
CertificateExpirationDate	8/10/2024
FacilityType	Waiver

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