33D2294743 CLIA NUMBER - WALGREENS NO 17665

Laboratory Demographics

  • CLIA Code: 33D2294743
  • Facility Name: WALGREENS NO 17665
  • Facility Address: 3480 JEROME AVE
    BRONX, NY
    ZIP 10467
  • Facility Phone: 718 231-2609
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1063939866
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2294743
LAB Type Pharmacy
Facility Name WALGREENS NO 17665
Street 3480 JEROME AVE
City BRONX
State NY
ZIP 10467
Phone 718 231-2609
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
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: 6/4/2025