50D2050636 CLIA NUMBER - SAFEWAY PHARMACY 1864

Laboratory Demographics

  • CLIA Code: 50D2050636
  • Facility Name: SAFEWAY PHARMACY 1864
  • Facility Address: 24040 BOTHELL EVERETT HWY
    BOTHELL, WA
    ZIP 98021
  • Facility Phone: 425 482-2829
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1467732735
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2050636
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 1864
Street 24040 BOTHELL EVERETT HWY
City BOTHELL
State WA
ZIP 98021
Phone 425 482-2829
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