33D2237919 CLIA NUMBER - WALGREENS NO 17097

Laboratory Demographics

  • CLIA Code: 33D2237919
  • Facility Name: WALGREENS NO 17097
  • Facility Address: 1616 BLACK RIVER BLVD
    ROME, NY
    ZIP 13440
  • Facility Phone: 315 339-5290
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1689193674
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2237919
LAB Type Pharmacy
Facility Name WALGREENS NO 17097
Street 1616 BLACK RIVER BLVD
City ROME
State NY
ZIP 13440
Phone 315 339-5290
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