13D2082238 CLIA NUMBER - SAFEWAY PHARMACY #2954

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Laboratory Demographics

CLIA Number: 13D2082238

Facility Name: SAFEWAY PHARMACY #2954

Facility Address:
6519 MAIN ST
BONNERS FERRY, ID
ZIP 83805
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Facility Phone Number: 208 267-2301

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1770594806

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	13D2082238
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY #2954
Street	6519 MAIN ST
City	BONNERS FERRY
State	ID
ZIP	83805
Phone	208 267-2301
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