03D2044315 CLIA NUMBER - FRYS FOOD AND DRUG #78

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Laboratory Demographics

CLIA Number: 03D2044315

Facility Name: FRYS FOOD AND DRUG #78

Facility Address:
39508 N DAISY MOUNTAIN DR
ANTHEM, AZ
ZIP 85086
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Facility Phone Number: 623 551-7221

Facility Type: Other - RETAIL PHARMACY

Certificate Type: Waiver

NPI Number: 1790852374

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	03D2044315
LAB Type	Other - RETAIL PHARMACY
Facility Name	FRYS FOOD AND DRUG #78
Street	39508 N DAISY MOUNTAIN DR
City	ANTHEM
State	AZ
ZIP	85086
Phone	623 551-7221
CertificateType	4
CertificateEffectiveDate	7/20/2022
CertificateExpirationDate	7/19/2024
FacilityType	Waiver

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