33D2243372 CLIA NUMBER - WALGREENS NO 05956

Laboratory Demographics

  • CLIA Code: 33D2243372
  • Facility Name: WALGREENS NO 05956
  • Facility Address: 275 BROADWAY
    AMITYVILLE, NY
    ZIP 11701
  • Facility Phone: 631 841-1630
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1609881770
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2243372
LAB Type Pharmacy
Facility Name WALGREENS NO 05956
Street 275 BROADWAY
City AMITYVILLE
State NY
ZIP 11701
Phone 631 841-1630
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2021
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