33D2216974 CLIA NUMBER - WALGREENS #11142

Laboratory Demographics

  • CLIA Code: 33D2216974
  • Facility Name: WALGREENS #11142
  • Facility Address: 9217 MAIN ST
    CLARENCE, NY
    ZIP 14031
  • Facility Phone: 716 634-7901
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1588851307
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2216974
LAB Type Pharmacy
Facility Name WALGREENS #11142
Street 9217 MAIN ST
City CLARENCE
State NY
ZIP 14031
Phone 716 634-7901
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2021
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