50D2058469 CLIA NUMBER - SAFEWAY PHARMACY #1572

Laboratory Demographics

  • CLIA Code: 50D2058469
  • Facility Name: SAFEWAY PHARMACY #1572
  • Facility Address: 14020 MAIN ST NE
    DUVALL, WA
    ZIP 98019
  • Facility Phone: 425 844-1199
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1366488124
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2058469
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1572
Street 14020 MAIN ST NE
City DUVALL
State WA
ZIP 98019
Phone 425 844-1199
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