33D2243380 CLIA NUMBER - WALGREENS NO 17736

Laboratory Demographics

  • CLIA Code: 33D2243380
  • Facility Name: WALGREENS NO 17736
  • Facility Address: 381 BROADWAY
    MONTICELLO, NY
    ZIP 12701
  • Facility Phone: 845 791-1301
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1649793589
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2243380
LAB Type Pharmacy
Facility Name WALGREENS NO 17736
Street 381 BROADWAY
City MONTICELLO
State NY
ZIP 12701
Phone 845 791-1301
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