27D1043749 CLIA NUMBER - SAFEWAY PHARMACY #2106

Laboratory Demographics

  • CLIA Code: 27D1043749
  • Facility Name: SAFEWAY PHARMACY #2106
  • Facility Address: 6580 HIGHWAY 93 SOUTH
    WHITEFISH, MT
    ZIP 59937
  • Facility Phone: 406 862-2526
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEROD VRADENBURG
  • NPI Number: 1568491587
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 27D1043749
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2106
Street 6580 HIGHWAY 93 SOUTH
City WHITEFISH
State MT
ZIP 59937
Phone 406 862-2526
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2024
Certificate Expiration Date 8/30/2026
Facility Type Pharmacy
Lab Director JEROD VRADENBURG

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