CLIA lab

CLIA 05D2091907: Safeway Pharmacy # 1592

Kings Beach, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 05D2091907 belongs to Safeway Pharmacy # 1592 in Kings Beach, CA.

Certificate of Waiver, effective February 20, 2025, expires February 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
February 20, 2025
Certificate expiration
February 19, 2027
Status in the CMS file
Active (termination code 00)
Original participation date
February 20, 2015
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
05D2091907
Lab name
Safeway Pharmacy # 1592
Address
7815 North Lake Boulevard, Kings Beach, CA 96143
Phone
(530) 546-0186
Fax
(530) 546-0277

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.

Related

Questions

What is the CLIA number for Safeway Pharmacy # 1592 in Kings Beach?

05D2091907, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does Safeway Pharmacy # 1592 hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 05D2091907 expire?

The CMS file lists February 19, 2027 as the certificate expiration date; the certificate took effect February 20, 2025.

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