50D2197126 CLIA NUMBER - SAFEWAY PHARMACY #1135

Laboratory Demographics

  • CLIA Code: 50D2197126
  • Facility Name: SAFEWAY PHARMACY #1135
  • Facility Address: 804 W 1ST ST
    CLE ELUM, WA
    ZIP 98922
  • Facility Phone: 509 852-3006
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1942744149
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2197126
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #1135
Street 804 W 1ST ST
City CLE ELUM
State WA
ZIP 98922
Phone 509 852-3006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2020
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