33D2227785 CLIA NUMBER - WALGREENS NO 11717

Laboratory Demographics

  • CLIA Code: 33D2227785
  • Facility Name: WALGREENS NO 11717
  • Facility Address: 863 MONTAUK HWY
    SHIRLEY, NY
    ZIP 11967
  • Facility Phone: 631 399-1352
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOURI
  • NPI Number: 1063719805
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 33D2227785
LAB Type Pharmacy
Facility Name WALGREENS NO 11717
Street 863 MONTAUK HWY
City SHIRLEY
State NY
ZIP 11967
Phone 631 399-1352
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2021
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director DR. ZEIAD FAKHOURI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025