50D2050629 CLIA NUMBER - SAFEWAY PHARMACY 1528

Laboratory Demographics

  • CLIA Code: 50D2050629
  • Facility Name: SAFEWAY PHARMACY 1528
  • Facility Address: 460 SW MOUNT SI BLVD
    NORTH BEND, WA
    ZIP 98045
  • Facility Phone: 425 831-2126
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1376572396
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2050629
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 1528
Street 460 SW MOUNT SI BLVD
City NORTH BEND
State WA
ZIP 98045
Phone 425 831-2126
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: 6/4/2025