03D2111590 CLIA NUMBER - FRY'S PHARMACY #657

Laboratory Demographics

  • CLIA Code: 03D2111590
  • Facility Name: FRY'S PHARMACY #657
  • Facility Address: 25401 N LAKE PLEASANT PARKWAY
    PEORIA, AZ
    ZIP 85383
  • Facility Phone: 623 907-4932
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WHITNEY RICE
  • NPI Number: 1942756812
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2111590
LAB Type Pharmacy
Facility Name FRY'S PHARMACY #657
Street 25401 N LAKE PLEASANT PARKWAY
City PEORIA
State AZ
ZIP 85383
Phone 623 907-4932
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Pharmacy
Lab Director WHITNEY RICE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025