33D2243404 CLIA NUMBER - WALGREENS NO 12690

Laboratory Demographics

  • CLIA Code: 33D2243404
  • Facility Name: WALGREENS NO 12690
  • Facility Address: 121 OLD RTE 146
    CLIFTON PARK, NY
    ZIP 12065
  • Facility Phone: 518 371-5842
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1215242110
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2243404
LAB Type Pharmacy
Facility Name WALGREENS NO 12690
Street 121 OLD RTE 146
City CLIFTON PARK
State NY
ZIP 12065
Phone 518 371-5842
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