53D2074993 CLIA NUMBER - SAFEWAY PHARMACY #2761

Laboratory Demographics

  • CLIA Code: 53D2074993
  • Facility Name: SAFEWAY PHARMACY #2761
  • Facility Address: 1165 MAIN ST
    LANDER, WY
    ZIP 82520
  • Facility Phone: 307 332-3939
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CALVIN J. CULVER
  • NPI Number: 1649509415
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2074993
LAB Type Pharmacy
Facility Name SAFEWAY PHARMACY #2761
Street 1165 MAIN ST
City LANDER
State WY
ZIP 82520
Phone 307 332-3939
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Pharmacy
Lab Director CALVIN J. CULVER

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This page was last updated on: 9/29/2025