33D2237903 CLIA NUMBER - WALGREENS NO 11904

Laboratory Demographics

  • CLIA Code: 33D2237903
  • Facility Name: WALGREENS NO 11904
  • Facility Address: 8 W MAIN ST
    LE ROY, NY
    ZIP 14482
  • Facility Phone: 585 768-9550
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1114152642
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2237903
LAB Type Pharmacy
Facility Name WALGREENS NO 11904
Street 8 W MAIN ST
City LE ROY
State NY
ZIP 14482
Phone 585 768-9550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2021
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