33D2294148 CLIA NUMBER - WALGREENS NO 05074

Laboratory Demographics

  • CLIA Code: 33D2294148
  • Facility Name: WALGREENS NO 05074
  • Facility Address: 55 WESTCHESTER SQ
    BRONX, NY
    ZIP 10461
  • Facility Phone: 718 239-6149
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1679588743
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2294148
LAB Type Pharmacy
Facility Name WALGREENS NO 05074
Street 55 WESTCHESTER SQ
City BRONX
State NY
ZIP 10461
Phone 718 239-6149
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
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