28D2110996 CLIA NUMBER - SAFEWAY PHARMACY #2555

Laboratory Demographics

  • CLIA Code: 28D2110996
  • Facility Name: SAFEWAY PHARMACY #2555
  • Facility Address: 1944 ILLINOIS STREET
    SIDNEY, NE
    ZIP 69162
  • Facility Phone: 308 254-4531
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. MICHAEL HICKS
  • NPI Number: 1821027848
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2110996
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2555
Street 1944 ILLINOIS STREET
City SIDNEY
State NE
ZIP 69162
Phone 308 254-4531
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2024
Certificate Expiration Date 3/28/2026
Facility Type Pharmacy
Lab Director MR. MICHAEL HICKS

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