50D2058367 CLIA NUMBER - SAFEWAY PHARMACY 1977

Laboratory Demographics

  • CLIA Code: 50D2058367
  • Facility Name: SAFEWAY PHARMACY 1977
  • Facility Address: 6200 PACIFIC AVE SE
    LACEY, WA
    ZIP 98503
  • Facility Phone: 360 486-3401
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1801827613
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2058367
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY 1977
Street 6200 PACIFIC AVE SE
City LACEY
State WA
ZIP 98503
Phone 360 486-3401
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2013
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