33D2240576 CLIA NUMBER - WALGREENS NO 18030

Laboratory Demographics

  • CLIA Code: 33D2240576
  • Facility Name: WALGREENS NO 18030
  • Facility Address: 1161 NYS RTE 9N
    TICONDEROGA, NY
    ZIP 12883
  • Facility Phone: 518 585-6787
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1528582822
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2240576
LAB Type Pharmacy
Facility Name WALGREENS NO 18030
Street 1161 NYS RTE 9N
City TICONDEROGA
State NY
ZIP 12883
Phone 518 585-6787
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