50D1023465 CLIA NUMBER - SAFEWAY PHARMACY 459

Laboratory Demographics

  • CLIA Code: 50D1023465
  • Facility Name: SAFEWAY PHARMACY 459
  • Facility Address: 20830 108TH AVE SE
    KENT, WA
    ZIP 98031
  • Facility Phone: 253 852-9319
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1134158157
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D1023465
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 459
Street 20830 108TH AVE SE
City KENT
State WA
ZIP 98031
Phone 253 852-9319
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2013
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