29D2208783 CLIA NUMBER - SAFEWAY PHARMACY #2656

Laboratory Demographics

  • CLIA Code: 29D2208783
  • Facility Name: SAFEWAY PHARMACY #2656
  • Facility Address: 2858 VISTA BLVD
    SPARKS, NV
    ZIP 89434
  • Facility Phone: (775) 352-8475
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIANNE GUSTILO
  • NPI Number: 1700287406
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 29D2208783
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2656
Street 2858 VISTA BLVD
City SPARKS
State NV
ZIP 89434
Phone 7753528475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2025
Certificate Expiration Date 1/7/2027
Facility Type Pharmacy
Lab Director BRIANNE GUSTILO

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This page was last updated on: 5/18/2026