33D2237094 CLIA NUMBER - WALGREENS NO 17195

Laboratory Demographics

  • CLIA Code: 33D2237094
  • Facility Name: WALGREENS NO 17195
  • Facility Address: 79 NORTH ST
    DRYDEN, NY
    ZIP 13053
  • Facility Phone: 607 844-3404
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1508383472
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2237094
LAB Type Pharmacy
Facility Name WALGREENS NO 17195
Street 79 NORTH ST
City DRYDEN
State NY
ZIP 13053
Phone 607 844-3404
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 A. FAKHOURI

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