33D2296131 CLIA NUMBER - WALGREENS NO 17461

Laboratory Demographics

  • CLIA Code: 33D2296131
  • Facility Name: WALGREENS NO 17461
  • Facility Address: 212 NORTH MAIN STREET
    NORTHVILLE, NY
    ZIP 12134
  • Facility Phone: 518 863-6524
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1588180202
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2296131
LAB Type Pharmacy
Facility Name WALGREENS NO 17461
Street 212 NORTH MAIN STREET
City NORTHVILLE
State NY
ZIP 12134
Phone 518 863-6524
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: 9/29/2025