33D2294290 CLIA NUMBER - WALGREENS NO 13866

Laboratory Demographics

  • CLIA Code: 33D2294290
  • Facility Name: WALGREENS NO 13866
  • Facility Address: 302 ROUTE 25A
    MILLER PLACE, NY
    ZIP 11764
  • Facility Phone: 631 331-3162
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1285072108
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2294290
LAB Type Pharmacy
Facility Name WALGREENS NO 13866
Street 302 ROUTE 25A
City MILLER PLACE
State NY
ZIP 11764
Phone 631 331-3162
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