50D2039609 CLIA NUMBER - SAFEWAY PHARMACY 1493

Laboratory Demographics

  • CLIA Code: 50D2039609
  • Facility Name: SAFEWAY PHARMACY 1493
  • Facility Address: 4011 S 164TH ST
    SEATAC, WA
    ZIP 98188
  • Facility Phone: 206 248-0300
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN N. TEGART
  • NPI Number: 1396774311
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2039609
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 1493
Street 4011 S 164TH ST
City SEATAC
State WA
ZIP 98188
Phone 206 248-0300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2012
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director SUSAN N. TEGART

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