50D2053401 CLIA NUMBER - SAFEWAY PHARMACY 0555

Laboratory Demographics

  • CLIA Code: 50D2053401
  • Facility Name: SAFEWAY PHARMACY 0555
  • Facility Address: 630 228TH AVE NE
    SAMMAMISH, WA
    ZIP 98074
  • Facility Phone: 425 868-6181
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1518903103
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2053401
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 0555
Street 630 228TH AVE NE
City SAMMAMISH
State WA
ZIP 98074
Phone 425 868-6181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2013
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