50D2053409 CLIA NUMBER - SAFEWAY PHARMACY 1173

Laboratory Demographics

  • CLIA Code: 50D2053409
  • Facility Name: SAFEWAY PHARMACY 1173
  • Facility Address: 1243 MARVIN RD NE
    LACEY, WA
    ZIP 98516
  • Facility Phone: 360 252-2235
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1538190343
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2053409
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 1173
Street 1243 MARVIN RD NE
City LACEY
State WA
ZIP 98516
Phone 360 252-2235
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