50D2053414 CLIA NUMBER - SAFEWAY PHARMACY 1645

Laboratory Demographics

  • CLIA Code: 50D2053414
  • Facility Name: SAFEWAY PHARMACY 1645
  • Facility Address: 10223 GRAVELLY LAKE DR SW
    LAKEWOOD, WA
    ZIP 98499
  • Facility Phone: 253 581-7181
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN M. TEGART
  • NPI Number: 1942239967
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2053414
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 1645
Street 10223 GRAVELLY LAKE DR SW
City LAKEWOOD
State WA
ZIP 98499
Phone 253 581-7181
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 M. TEGART

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