03D2111590 CLIA NUMBER - FRY'S PHARMACY #657

Laboratory Demographics

CLIA Number: 03D2111590

Facility Name: FRY'S PHARMACY #657

Facility Address:
25401 N LAKE PLEASANT PARKWAY
PEORIA, AZ
ZIP 85383
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Facility Phone Number: (623) 907-4932

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1942756812

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	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

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This page was last updated on: 5/11/2023