33D2212236 CLIA NUMBER - WALGREENS #15369

Laboratory Demographics

  • CLIA Code: 33D2212236
  • Facility Name: WALGREENS #15369
  • Facility Address: 290 W MERRICK RD
    VALLEY STREAM, NY
    ZIP 11580
  • Facility Phone: 516 612-9121
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1518343813
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2212236
LAB Type Pharmacy
Facility Name WALGREENS #15369
Street 290 W MERRICK RD
City VALLEY STREAM
State NY
ZIP 11580
Phone 516 612-9121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2021
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