03D2095030 CLIA NUMBER - FRY'S FOOD AND DRUG

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Laboratory Demographics

CLIA Number: 03D2095030

Facility Name: FRY'S FOOD AND DRUG

Facility Address:
15215 N COTTON LANE
SURPRISE, AZ
ZIP 85388
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Facility Phone Number: 623 455-7902

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1861627648

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	03D2095030
LAB Type	Pharmacy
Facility Name	FRY'S FOOD AND DRUG
Street	15215 N COTTON LANE
City	SURPRISE
State	AZ
ZIP	85388
Phone	623 455-7902
CertificateType	4
CertificateEffectiveDate	4/28/2023
CertificateExpirationDate	4/27/2025
FacilityType	Waiver

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