27D2083946 CLIA NUMBER - SAFEWAY PHARMACY # 1158

Laboratory Demographics

  • CLIA Code: 27D2083946
  • Facility Name: SAFEWAY PHARMACY # 1158
  • Facility Address: 201 N MAIN ST
    DEER LODGE, MT
    ZIP 59722
  • Facility Phone: 406 846-1414
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN SWANSON
  • NPI Number: 1386673309
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 27D2083946
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY # 1158
Street 201 N MAIN ST
City DEER LODGE
State MT
ZIP 59722
Phone 406 846-1414
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Pharmacy
Lab Director KEVIN SWANSON

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