50D2053404 CLIA NUMBER - SAFEWAY PHARMACY 1484

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Laboratory Demographics

CLIA Number: 50D2053404

Facility Name: SAFEWAY PHARMACY 1484

Facility Address:
4128 RUCKER AVE
EVERETT, WA
ZIP 98201
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Facility Phone Number: 425 252-1911

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1104857903

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	50D2053404
LAB Type	Pharmacy
Facility Name	SAFEWAY PHARMACY 1484
Street	4128 RUCKER AVE
City	EVERETT
State	WA
ZIP	98201
Phone	425 252-1911
CertificateType	4
CertificateEffectiveDate	1/31/2013
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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This page was last updated on: 4/23/2024