33D2294284 CLIA NUMBER - WALGREENS NO 19981

Laboratory Demographics

  • CLIA Code: 33D2294284
  • Facility Name: WALGREENS NO 19981
  • Facility Address: 10095 ROUTE 25
    MATTITUCK, NY
    ZIP 11952
  • Facility Phone: 631 298-5601
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1972029056
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2294284
LAB Type Pharmacy
Facility Name WALGREENS NO 19981
Street 10095 ROUTE 25
City MATTITUCK
State NY
ZIP 11952
Phone 631 298-5601
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2023
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