33D2240903 CLIA NUMBER - WALGREENS NO 19496

Laboratory Demographics

  • CLIA Code: 33D2240903
  • Facility Name: WALGREENS NO 19496
  • Facility Address: 4764 SALINA ST
    PULASKI, NY
    ZIP 13142
  • Facility Phone: 315 298-6027
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1275058935
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2240903
LAB Type Pharmacy
Facility Name WALGREENS NO 19496
Street 4764 SALINA ST
City PULASKI
State NY
ZIP 13142
Phone 315 298-6027
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