50D2050624 CLIA NUMBER - SAFEWAY PHARMACY 0490

Laboratory Demographics

  • CLIA Code: 50D2050624
  • Facility Name: SAFEWAY PHARMACY 0490
  • Facility Address: 1645 140TH AVE NE
    BELLEVUE, WA
    ZIP 98005
  • Facility Phone: 425 643-1778
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1053340083
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2050624
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 0490
Street 1645 140TH AVE NE
City BELLEVUE
State WA
ZIP 98005
Phone 425 643-1778
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2012
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