50D2010723 CLIA NUMBER - SAFEWAY PHARMACY #0494

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Laboratory Demographics

CLIA Number: 50D2010723

Facility Name: SAFEWAY PHARMACY #0494

Facility Address:
152 ROOSEVELT AVE
ENUMCLAW, WA
ZIP 98022
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Facility Phone Number: 360 802-1534

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1003842881

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	50D2010723
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY #0494
Street	152 ROOSEVELT AVE
City	ENUMCLAW
State	WA
ZIP	98022
Phone	360 802-1534
CertificateType	4
CertificateEffectiveDate	5/7/2013
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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This page was last updated on: 4/23/2024