38D2081025 CLIA NUMBER - SAFEWAY PHARMACY #1458

Laboratory Demographics

  • CLIA Code: 38D2081025
  • Facility Name: SAFEWAY PHARMACY #1458
  • Facility Address: 1500 E MAIN ST
    COTTAGE GROVE, OR
    ZIP 97424
  • Facility Phone: 541 942-7443
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW EGGEN
  • NPI Number: 1215966254
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2081025
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1458
Street 1500 E MAIN ST
City COTTAGE GROVE
State OR
ZIP 97424
Phone 541 942-7443
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type Pharmacy
Lab Director MATTHEW EGGEN

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