50D2053415 CLIA NUMBER - SAFEWAY PHARMACY 0547

Laboratory Demographics

  • CLIA Code: 50D2053415
  • Facility Name: SAFEWAY PHARMACY 0547
  • Facility Address: 10105 224TH ST E
    GRAHAM, WA
    ZIP 98338
  • Facility Phone: 253 847-7634
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1154367746
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2053415
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 0547
Street 10105 224TH ST E
City GRAHAM
State WA
ZIP 98338
Phone 253 847-7634
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