CLIA lab
CLIA 05D2059176: Safeway Pharmacy #1631
Vallejo, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2059176 belongs to Safeway Pharmacy #1631 in Vallejo, CA.
Certificate of Waiver, effective May 20, 2025, expires May 19, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- May 20, 2025
- Certificate expiration
- May 19, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 20, 2013
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D2059176
- Lab name
- Safeway Pharmacy #1631
- Address
- 122 Robles Way, Vallejo, CA 94591
- Phone
- (707) 554-6908
- Fax
- (707) 554-2347
Annual test volume the lab reported
- Waived tests
- 1,000
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Concepcion and Lim, MD Family Practice, P CCertificate for Provider-Performed Microscopy Procedures, Physician office05D0997744
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Related
Questions
What is the CLIA number for Safeway Pharmacy #1631 in Vallejo?
05D2059176, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Safeway Pharmacy #1631 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2059176 expire?
The CMS file lists May 19, 2027 as the certificate expiration date; the certificate took effect May 20, 2025.