33D2240889 CLIA NUMBER - WALGREENS NO 19684

Laboratory Demographics

  • CLIA Code: 33D2240889
  • Facility Name: WALGREENS NO 19684
  • Facility Address: 330 PINE TREE RD
    ITHACA, NY
    ZIP 14850
  • Facility Phone: 607 273-2035
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1972029650
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2240889
LAB Type Pharmacy
Facility Name WALGREENS NO 19684
Street 330 PINE TREE RD
City ITHACA
State NY
ZIP 14850
Phone 607 273-2035
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2021
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