50D2053330 CLIA NUMBER - SAFEWAY PHARMACY 0497

Laboratory Demographics

  • CLIA Code: 50D2053330
  • Facility Name: SAFEWAY PHARMACY 0497
  • Facility Address: 17202 15TH AVE NE
    SHORELINE, WA
    ZIP 98155
  • Facility Phone: 206 364-4618
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1669418273
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2053330
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 0497
Street 17202 15TH AVE NE
City SHORELINE
State WA
ZIP 98155
Phone 206 364-4618
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 TEGART

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