33D2219751 CLIA NUMBER - WALGREENS #10591

Laboratory Demographics

  • CLIA Code: 33D2219751
  • Facility Name: WALGREENS #10591
  • Facility Address: 305 W MAIN ST
    MALONE, NY
    ZIP 12953
  • Facility Phone: 518 483-9090
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1063623841
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2219751
LAB Type Pharmacy
Facility Name WALGREENS #10591
Street 305 W MAIN ST
City MALONE
State NY
ZIP 12953
Phone 518 483-9090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2021
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