50D1034877 CLIA NUMBER - SAFEWAY PHARMACY #1413

Laboratory Demographics

  • CLIA Code: 50D1034877
  • Facility Name: SAFEWAY PHARMACY #1413
  • Facility Address: 3322 132ND ST SE
    MILL CREEK, WA
    ZIP 98012
  • Facility Phone: (425) 338-1891
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN M. TEGART
  • NPI Number: 1760438279
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D1034877
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1413
Street 3322 132ND ST SE
City MILL CREEK
State WA
ZIP 98012
Phone 4253381891
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2004
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director SUSAN M. TEGART

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This page was last updated on: 5/15/2026