38D2081029 CLIA NUMBER - SAFEWAY PHARMACY #1558

Laboratory Demographics

  • CLIA Code: 38D2081029
  • Facility Name: SAFEWAY PHARMACY #1558
  • Facility Address: 1983 S MAIN ST
    LEBANON, OR
    ZIP 97355
  • Facility Phone: 541 259-5706
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDY G. DAVIS
  • NPI Number: 1447289475
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2081029
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1558
Street 1983 S MAIN ST
City LEBANON
State OR
ZIP 97355
Phone 541 259-5706
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 BRANDY G. DAVIS

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This page was last updated on: 6/4/2025