50D2058457 CLIA NUMBER - SAFEWAY PHARMACY #1495

Laboratory Demographics

  • CLIA Code: 50D2058457
  • Facility Name: SAFEWAY PHARMACY #1495
  • Facility Address: 1129 HARRISON AVE
    CENTRALIA, WA
    ZIP 98531
  • Facility Phone: 360 330-5229
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART,
  • NPI Number: 1598701187
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2058457
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1495
Street 1129 HARRISON AVE
City CENTRALIA
State WA
ZIP 98531
Phone 360 330-5229
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/8/2013
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