33D2295734 CLIA NUMBER - WALGREENS NO 12067

Laboratory Demographics

  • CLIA Code: 33D2295734
  • Facility Name: WALGREENS NO 12067
  • Facility Address: 416 WINDSOR HWY
    VAILS GATE, NY
    ZIP 12584
  • Facility Phone: 845 562-4010
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1750664975
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2295734
LAB Type Pharmacy
Facility Name WALGREENS NO 12067
Street 416 WINDSOR HWY
City VAILS GATE
State NY
ZIP 12584
Phone 845 562-4010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2023
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