43D2109893 CLIA NUMBER - SAFEWAY PHARMACY 1554

Laboratory Demographics

  • CLIA Code: 43D2109893
  • Facility Name: SAFEWAY PHARMACY 1554
  • Facility Address: 730 MOUNTAIN VIEW ROAD
    RAPID CITY, SD
    ZIP 57702
  • Facility Phone: 605 342-8505
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BETH SUNDAHL
  • NPI Number: 1538198593
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 43D2109893
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 1554
Street 730 MOUNTAIN VIEW ROAD
City RAPID CITY
State SD
ZIP 57702
Phone 605 342-8505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2024
Certificate Expiration Date 3/3/2026
Facility Type Pharmacy
Lab Director BETH SUNDAHL

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