50D0975325 CLIA NUMBER - SAFEWAY PHARMACY #1687

Laboratory Demographics

  • CLIA Code: 50D0975325
  • Facility Name: SAFEWAY PHARMACY #1687
  • Facility Address: 3307 SE EVERGREEN WAY STE 5
    WASHOUGAL, WA
    ZIP 98671
  • Facility Phone: 360 335-2006
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1720017742
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D0975325
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1687
Street 3307 SE EVERGREEN WAY STE 5
City WASHOUGAL
State WA
ZIP 98671
Phone 360 335-2006
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: 6/4/2025