33D2295845 CLIA NUMBER - WALGREENS NO 17161

Laboratory Demographics

  • CLIA Code: 33D2295845
  • Facility Name: WALGREENS NO 17161
  • Facility Address: 11910 LIBERTY AVE
    SOUTH RICHMOND HILL, NY
    ZIP 11419
  • Facility Phone: 718 835-7659
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1003332131
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2295845
LAB Type Pharmacy
Facility Name WALGREENS NO 17161
Street 11910 LIBERTY AVE
City SOUTH RICHMOND HILL
State NY
ZIP 11419
Phone 718 835-7659
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