33D2294496 CLIA NUMBER - WALGREENS NO 04565

Laboratory Demographics

  • CLIA Code: 33D2294496
  • Facility Name: WALGREENS NO 04565
  • Facility Address: 12704 GUY R BREWER BLVD
    JAMAICA, NY
    ZIP 11434
  • Facility Phone: 718 978-4458
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1811902968
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2294496
LAB Type Pharmacy
Facility Name WALGREENS NO 04565
Street 12704 GUY R BREWER BLVD
City JAMAICA
State NY
ZIP 11434
Phone 718 978-4458
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/28/2023
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