33D2237930 CLIA NUMBER - WALGREENS NO 17494

Laboratory Demographics

  • CLIA Code: 33D2237930
  • Facility Name: WALGREENS NO 17494
  • Facility Address: 2460 STATE RTE 52
    PINE BUSH, NY
    ZIP 12566
  • Facility Phone: 845 744-8845
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1982127916
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2237930
LAB Type Pharmacy
Facility Name WALGREENS NO 17494
Street 2460 STATE RTE 52
City PINE BUSH
State NY
ZIP 12566
Phone 845 744-8845
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