33D2293578 CLIA NUMBER - WALGREENS NO 15212

Laboratory Demographics

  • CLIA Code: 33D2293578
  • Facility Name: WALGREENS NO 15212
  • Facility Address: 411 KING ST
    CHAPPAQUA, NY
    ZIP 10514
  • Facility Phone: 914 861-9130
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1568802767
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2293578
LAB Type Pharmacy
Facility Name WALGREENS NO 15212
Street 411 KING ST
City CHAPPAQUA
State NY
ZIP 10514
Phone 914 861-9130
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
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