33D2237062 CLIA NUMBER - WALGREENS NO 05714

Laboratory Demographics

  • CLIA Code: 33D2237062
  • Facility Name: WALGREENS NO 05714
  • Facility Address: 578 DICK RD
    DEPEW, NY
    ZIP 14043
  • Facility Phone: 716 568-1239
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD FAKHOVRI
  • NPI Number: 1669510343
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2237062
LAB Type Pharmacy
Facility Name WALGREENS NO 05714
Street 578 DICK RD
City DEPEW
State NY
ZIP 14043
Phone 716 568-1239
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2021
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director DR. ZEIAD FAKHOVRI

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