33D2196549 CLIA NUMBER - WALGREENS NO 12490

Laboratory Demographics

  • CLIA Code: 33D2196549
  • Facility Name: WALGREENS NO 12490
  • Facility Address: 13250 METROPOLITAN AVE
    SOUTH RICHMOND HILL, NY
    ZIP 11419
  • Facility Phone: 645 584-7486
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1265959779
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2196549
LAB Type Pharmacy
Facility Name WALGREENS NO 12490
Street 13250 METROPOLITAN AVE
City SOUTH RICHMOND HILL
State NY
ZIP 11419
Phone 645 584-7486
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2020
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director DR. ZEIAD FAKHOURI

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This page was last updated on: 9/29/2025