33D2243398 CLIA NUMBER - WALGREENS NO 19811

Laboratory Demographics

  • CLIA Code: 33D2243398
  • Facility Name: WALGREENS NO 19811
  • Facility Address: 1934 STATE RTE 52
    LIBERTY, NY
    ZIP 12754
  • Facility Phone: 845 292-4114
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1427573567
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2243398
LAB Type Pharmacy
Facility Name WALGREENS NO 19811
Street 1934 STATE RTE 52
City LIBERTY
State NY
ZIP 12754
Phone 845 292-4114
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