50D2264302 CLIA NUMBER - SAFEWAY PHARMACY #3414

Laboratory Demographics

  • CLIA Code: 50D2264302
  • Facility Name: SAFEWAY PHARMACY #3414
  • Facility Address: 450 N WILBUR AVE
    WALLA WALLA, WA
    ZIP 99362
  • Facility Phone: 509 529-2008
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1306291133
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2264302
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #3414
Street 450 N WILBUR AVE
City WALLA WALLA
State WA
ZIP 99362
Phone 509 529-2008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2022
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director SUSAN TEGART

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This page was last updated on: 6/4/2025