50D0975323 CLIA NUMBER - SAFEWAY PHARMACY #1704

Laboratory Demographics

  • CLIA Code: 50D0975323
  • Facility Name: SAFEWAY PHARMACY #1704
  • Facility Address: 6700 NE 162ND AVE STE 500
    VANCOUVER, WA
    ZIP 98682
  • Facility Phone: (360) 944-2686
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1699704627
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0975323
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1704
Street 6700 NE 162ND AVE STE 500
City VANCOUVER
State WA
ZIP 98682
Phone 3609442686
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: 5/18/2026