33D2227308 CLIA NUMBER - WALGREENS #12631

Laboratory Demographics

  • CLIA Code: 33D2227308
  • Facility Name: WALGREENS #12631
  • Facility Address: 2084 STATE ROUTE 208
    MONTGOMERY, NY
    ZIP 12549
  • Facility Phone: 845 769-9203
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1568779346
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2227308
LAB Type Pharmacy
Facility Name WALGREENS #12631
Street 2084 STATE ROUTE 208
City MONTGOMERY
State NY
ZIP 12549
Phone 845 769-9203
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2021
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