50D1033370 CLIA NUMBER - SAFEWAY PHARMACY 580

Laboratory Demographics

  • CLIA Code: 50D1033370
  • Facility Name: SAFEWAY PHARMACY 580
  • Facility Address: 14300 NE 20TH AVE
    VANCOUVER, WA
    ZIP 98686
  • Facility Phone: (360) 576-4844
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN M. TEGART
  • NPI Number: 1801842299
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D1033370
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 580
Street 14300 NE 20TH AVE
City VANCOUVER
State WA
ZIP 98686
Phone 3605764844
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2004
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director SUSAN M. TEGART

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This page was last updated on: 5/18/2026