33D2296179 CLIA NUMBER - WALGREENS NO 17396

Laboratory Demographics

  • CLIA Code: 33D2296179
  • Facility Name: WALGREENS NO 17396
  • Facility Address: 21 E STATE ST
    MOUNT MORRIS, NY
    ZIP 14510
  • Facility Phone: 585 658-9498
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1386168862
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2296179
LAB Type Pharmacy
Facility Name WALGREENS NO 17396
Street 21 E STATE ST
City MOUNT MORRIS
State NY
ZIP 14510
Phone 585 658-9498
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2023
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