03D2042931 CLIA NUMBER - FRYS FOOD AND DRUG #116

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Laboratory Demographics

CLIA Number: 03D2042931

Facility Name: FRYS FOOD AND DRUG #116

Facility Address:
950 FAIR STREET
PRESCOTT, AZ
ZIP 86301
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Facility Phone Number: 928 778-6887

Facility Type: Other - RETAIL PHARMACY

Certificate Type: Waiver

NPI Number: 1548201338

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	03D2042931
LAB Type	Other - RETAIL PHARMACY
Facility Name	FRYS FOOD AND DRUG #116
Street	950 FAIR STREET
City	PRESCOTT
State	AZ
ZIP	86301
Phone	928 778-6887
CertificateType	4
CertificateEffectiveDate	6/22/2022
CertificateExpirationDate	6/21/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024