33D2222814 CLIA NUMBER - WALGREENS #17717

Laboratory Demographics

  • CLIA Code: 33D2222814
  • Facility Name: WALGREENS #17717
  • Facility Address: 116 QUAKER ST
    GRANVILLE, NY
    ZIP 12832
  • Facility Phone: 518 642-2332
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1699291278
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2222814
LAB Type Pharmacy
Facility Name WALGREENS #17717
Street 116 QUAKER ST
City GRANVILLE
State NY
ZIP 12832
Phone 518 642-2332
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: 9/29/2025