03D2043430 CLIA NUMBER - FRYS FOOD AND DRUG #109

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Laboratory Demographics

CLIA Number: 03D2043430

Facility Name: FRYS FOOD AND DRUG #109

Facility Address:
2115 US HIGHWAY 60 STE 200
MIAMI, AZ
ZIP 85539
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Facility Phone Number: 928 425-8165

Facility Type: Other - RETAIL PHARMACY

Certificate Type: Waiver

NPI Number: 1801838420

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	03D2043430
LAB Type	Other - RETAIL PHARMACY
Facility Name	FRYS FOOD AND DRUG #109
Street	2115 US HIGHWAY 60 STE 200
City	MIAMI
State	AZ
ZIP	85539
Phone	928 425-8165
CertificateType	4
CertificateEffectiveDate	7/2/2022
CertificateExpirationDate	7/1/2024
FacilityType	Waiver

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