50D2058455 CLIA NUMBER - SAFEWAY PHARMACY #1471

Laboratory Demographics

  • CLIA Code: 50D2058455
  • Facility Name: SAFEWAY PHARMACY #1471
  • Facility Address: 26916 MAPLE VALLEY-BLACK DIAMOND RD
    MAPLE VALLEY, WA
    ZIP 98038
  • Facility Phone: 425 432-3077
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1710913595
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2058455
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1471
Street 26916 MAPLE VALLEY-BLACK DIAMOND RD
City MAPLE VALLEY
State WA
ZIP 98038
Phone 425 432-3077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2013
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