33D2295815 CLIA NUMBER - WALGREENS NO 17613

Laboratory Demographics

  • CLIA Code: 33D2295815
  • Facility Name: WALGREENS NO 17613
  • Facility Address: 90 01 SUTPHIN BOULEVARD
    JAMAICA, NY
    ZIP 11435
  • Facility Phone: 718 526-3824
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1518483213
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2295815
LAB Type Pharmacy
Facility Name WALGREENS NO 17613
Street 90 01 SUTPHIN BOULEVARD
City JAMAICA
State NY
ZIP 11435
Phone 718 526-3824
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2023
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