33D2296122 CLIA NUMBER - WALGREENS NO 02778

Laboratory Demographics

  • CLIA Code: 33D2296122
  • Facility Name: WALGREENS NO 02778
  • Facility Address: 2095 DUTCH BROADWAY
    ELMONT, NY
    ZIP 11003
  • Facility Phone: 516 285-4214
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1336154400
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2296122
LAB Type Pharmacy
Facility Name WALGREENS NO 02778
Street 2095 DUTCH BROADWAY
City ELMONT
State NY
ZIP 11003
Phone 516 285-4214
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2023
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