49D2249367 CLIA NUMBER - SAFEWAY PHARMACY #0005

Laboratory Demographics

  • CLIA Code: 49D2249367
  • Facility Name: SAFEWAY PHARMACY #0005
  • Facility Address: 11120 SOUTH LAKES DR
    RESTON, VA
    ZIP 20191
  • Facility Phone: 703 620-2444
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTA HEIN
  • NPI Number: 1316983935
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2249367
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #0005
Street 11120 SOUTH LAKES DR
City RESTON
State VA
ZIP 20191
Phone 703 620-2444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2024
Certificate Expiration Date 1/19/2026
Facility Type Pharmacy
Lab Director KRISTA HEIN

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