CLIA lab
CLIA 05D2079747: Safeway Pharmacy #2778
Jackson, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2079747 belongs to Safeway Pharmacy #2778 in Jackson, CA.
Certificate of Waiver, effective January 28, 2025, expires January 27, 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
- January 28, 2025
- Certificate expiration
- January 27, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 24, 2014
- 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
- 05D2079747
- Lab name
- Safeway Pharmacy #2778
- Address
- 12110 Industry Blvd, Jackson, CA 95642
- Phone
- (209) 257-0786
- Fax
- (209) 257-0790
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.
Other labs in Jackson, CA
- Amador Family Physicians Medical CorporationCertificate for Provider-Performed Microscopy Procedures, Physician office05D0984183
- Hospice of Amador & CalaverasCertificate of Waiver, Hospice05D0926617
- Irc-Sutter Health Jackson, LLCCertificate of Waiver, End stage renal disease dialysis facility05D2302474
- Jackson Rancheria Medical CenterCertificate of Waiver, Physician office05D2074377
- Kit Carson Nursing and RehabilitationCertificate of Waiver, Skilled nursing or nursing facility05D0725688
- Mact Dental, JacksonCertificate of Waiver, Ancillary test site05D2216008
- Mact Medical, JacksonCertificate for Provider-Performed Microscopy Procedures, Other05D0698999
- Sierra Eyecare AssociatesCertificate of Waiver, Other practitioner05D2173099
- Sutter Amador Surgery Center, LLCCertificate of Waiver, Ambulatory surgery center05D1036653
- Sutter-Amador Hospital LaboratoryCertificate of Accreditation, Hospital05D0063882
Related
Questions
What is the CLIA number for Safeway Pharmacy #2778 in Jackson?
05D2079747, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Safeway Pharmacy #2778 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2079747 expire?
The CMS file lists January 27, 2027 as the certificate expiration date; the certificate took effect January 28, 2025.