50D2014807 CLIA NUMBER - SAFEWAY PHARMACY 1159

Laboratory Demographics

  • CLIA Code: 50D2014807
  • Facility Name: SAFEWAY PHARMACY 1159
  • Facility Address: 121 W WALNUT ST
    NEWPORT, WA
    ZIP 99156
  • Facility Phone: 509 447-3972
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1013953645
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2014807
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 1159
Street 121 W WALNUT ST
City NEWPORT
State WA
ZIP 99156
Phone 509 447-3972
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2010
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