33D2222468 CLIA NUMBER - WALGREENS #04029

Laboratory Demographics

  • CLIA Code: 33D2222468
  • Facility Name: WALGREENS #04029
  • Facility Address: 209 ROUTE 59
    SUFFERN, NY
    ZIP 10901
  • Facility Phone: 845 369-1179
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1902811052
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2222468
LAB Type Pharmacy
Facility Name WALGREENS #04029
Street 209 ROUTE 59
City SUFFERN
State NY
ZIP 10901
Phone 845 369-1179
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2021
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