38D2274008 CLIA NUMBER - SAFEWAY PHARMACY #4262

Laboratory Demographics

  • CLIA Code: 38D2274008
  • Facility Name: SAFEWAY PHARMACY #4262
  • Facility Address: 3 E FIRST ST
    COQUILLE, OR
    ZIP 97423
  • Facility Phone: 541 396-2422
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATHAN HURLESS
  • NPI Number: 1134165731
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2274008
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #4262
Street 3 E FIRST ST
City COQUILLE
State OR
ZIP 97423
Phone 541 396-2422
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Pharmacy
Lab Director NATHAN HURLESS

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