29D2216668 CLIA NUMBER - SAFEWAY PHARMACY #1210

Laboratory Demographics

  • CLIA Code: 29D2216668
  • Facility Name: SAFEWAY PHARMACY #1210
  • Facility Address: 5150 MAE ANNE AVE STE 300
    RENO, NV
    ZIP 89523
  • Facility Phone: 775 746-9010
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ISRAEL D BANADERA
  • NPI Number: 1003852617
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 29D2216668
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1210
Street 5150 MAE ANNE AVE STE 300
City RENO
State NV
ZIP 89523
Phone 775 746-9010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Pharmacy
Lab Director ISRAEL D BANADERA

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