33D2222812 CLIA NUMBER - WALGREENS #09939

Laboratory Demographics

  • CLIA Code: 33D2222812
  • Facility Name: WALGREENS #09939
  • Facility Address: 709 W UNION ST
    NEWARK, NY
    ZIP 14513
  • Facility Phone: 315 332-0193
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1649356676
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2222812
LAB Type Pharmacy
Facility Name WALGREENS #09939
Street 709 W UNION ST
City NEWARK
State NY
ZIP 14513
Phone 315 332-0193
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2021
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director DR. ZEIAD FAKHOURI

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This page was last updated on: 6/4/2025