03D2001619 CLIA NUMBER - OSCO DRUG #0977

Laboratory Demographics

  • CLIA Code: 03D2001619
  • Facility Name: OSCO DRUG #0977
  • Facility Address: 14551 W GRAND AVE
    SURPRISE, AZ
    ZIP 85374
  • Facility Phone: 623 546-4085
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HUGO VARGAS CRUZ
  • NPI Number: 1114966595
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2001619
LAB Type Pharmacy
Facility Name OSCO DRUG #0977
Street 14551 W GRAND AVE
City SURPRISE
State AZ
ZIP 85374
Phone 623 546-4085
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Pharmacy
Lab Director HUGO VARGAS CRUZ

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