33D2212519 CLIA NUMBER - WALGREENS #04920

Laboratory Demographics

  • CLIA Code: 33D2212519
  • Facility Name: WALGREENS #04920
  • Facility Address: 918 MAIN ST STE 200
    SOUTH FARMINGDALE, NY
    ZIP 11735
  • Facility Phone: 917 667-5330
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1790790863
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2212519
LAB Type Pharmacy
Facility Name WALGREENS #04920
Street 918 MAIN ST STE 200
City SOUTH FARMINGDALE
State NY
ZIP 11735
Phone 917 667-5330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2021
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