50D1105763 CLIA NUMBER - SAFEWAY PHARMACY #4313

Laboratory Demographics

  • CLIA Code: 50D1105763
  • Facility Name: SAFEWAY PHARMACY #4313
  • Facility Address: 904 W MAIN ST
    BATTLEGROUND, WA
    ZIP 98604
  • Facility Phone: 360 723-9046
  • Facility Type: Industrial
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1487819876
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D1105763
LAB Type Industrial
Facility Name SAFEWAY PHARMACY #4313
Street 904 W MAIN ST
City BATTLEGROUND
State WA
ZIP 98604
Phone 360 723-9046
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2009
Certificate Expiration Date 4/4/2028
Facility Type Industrial
Lab Director SUSAN TEGART

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This page was last updated on: 9/29/2025