50D2053323 CLIA NUMBER - SAFEWAY PHARMACY 1619

Laboratory Demographics

  • CLIA Code: 50D2053323
  • Facility Name: SAFEWAY PHARMACY 1619
  • Facility Address: 1109 E YELM AVE
    YELM, WA
    ZIP 98597
  • Facility Phone: 360 458-8835
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN M. TEGART
  • NPI Number: 1508802372
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2053323
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 1619
Street 1109 E YELM AVE
City YELM
State WA
ZIP 98597
Phone 360 458-8835
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2013
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director SUSAN M. TEGART

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