03D1094475 CLIA NUMBER - FRY'S FOOD AND DRUG #77

Laboratory Demographics

  • CLIA Code: 03D1094475
  • Facility Name: FRY'S FOOD AND DRUG #77
  • Facility Address: 3198 WILLOW CREEK RD
    PRESCOTT, AZ
    ZIP 86305
  • Facility Phone: 928 778-3181
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DARREN COATES
  • NPI Number: 1689618993
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D1094475
LAB Type Pharmacy
Facility Name FRY'S FOOD AND DRUG #77
Street 3198 WILLOW CREEK RD
City PRESCOTT
State AZ
ZIP 86305
Phone 928 778-3181
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2025
Certificate Expiration Date 1/20/2027
Facility Type Pharmacy
Lab Director DARREN COATES

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