50D1012732 CLIA NUMBER - SAFEWAY PHARMACY #1762

Laboratory Demographics

  • CLIA Code: 50D1012732
  • Facility Name: SAFEWAY PHARMACY #1762
  • Facility Address: 1725 PACIFIC AVE
    WOODLAND, WA
    ZIP 98674
  • Facility Phone: 360 225-4375
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1144259177
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D1012732
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1762
Street 1725 PACIFIC AVE
City WOODLAND
State WA
ZIP 98674
Phone 360 225-4375
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2003
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