33D2240899 CLIA NUMBER - WALGREENS NO 19876

Laboratory Demographics

  • CLIA Code: 33D2240899
  • Facility Name: WALGREENS NO 19876
  • Facility Address: 1929 US RTE 20
    WATERLOO, NY
    ZIP 13165
  • Facility Phone: 315 539-5056
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1417472655
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2240899
LAB Type Pharmacy
Facility Name WALGREENS NO 19876
Street 1929 US RTE 20
City WATERLOO
State NY
ZIP 13165
Phone 315 539-5056
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