33D2219753 CLIA NUMBER - WALGREENS #10239

Laboratory Demographics

  • CLIA Code: 33D2219753
  • Facility Name: WALGREENS #10239
  • Facility Address: 1655 STATE ST
    WATERTOWN, NY
    ZIP 13601
  • Facility Phone: 315 785-1088
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1871642579
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2219753
LAB Type Pharmacy
Facility Name WALGREENS #10239
Street 1655 STATE ST
City WATERTOWN
State NY
ZIP 13601
Phone 315 785-1088
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