21D2081902 CLIA NUMBER - SAFEWAY PHARMACY #0105

Laboratory Demographics

  • CLIA Code: 21D2081902
  • Facility Name: SAFEWAY PHARMACY #0105
  • Facility Address: 10 KING STREET
    WALDORF, MD
    ZIP 20602
  • Facility Phone: 208 395-3963
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTA HEIN
  • NPI Number: 1952519696
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2081902
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0105
Street 10 KING STREET
City WALDORF
State MD
ZIP 20602
Phone 208 395-3963
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2024
Certificate Expiration Date 8/3/2026
Facility Type Pharmacy
Lab Director KRISTA HEIN

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