50D0975317 CLIA NUMBER - SAFEWAY PHARMACY #091

Laboratory Demographics

  • CLIA Code: 50D0975317
  • Facility Name: SAFEWAY PHARMACY #091
  • Facility Address: 1227 15TH AVE
    LONGVIEW, WA
    ZIP 98632
  • Facility Phone: 360 575-6606
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1982640579
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0975317
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #091
Street 1227 15TH AVE
City LONGVIEW
State WA
ZIP 98632
Phone 360 575-6606
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2000
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director SUSAN TEGART

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