33D2240544 CLIA NUMBER - WALGREENS NO 17776

Laboratory Demographics

  • CLIA Code: 33D2240544
  • Facility Name: WALGREENS NO 17776
  • Facility Address: 102 E SCHUYLER ST
    BOONVILLE, NY
    ZIP 13309
  • Facility Phone: 315 942-4476
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1487177333
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2240544
LAB Type Pharmacy
Facility Name WALGREENS NO 17776
Street 102 E SCHUYLER ST
City BOONVILLE
State NY
ZIP 13309
Phone 315 942-4476
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2021
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