33D2296187 CLIA NUMBER - WALGREENS NO 19777

Laboratory Demographics

  • CLIA Code: 33D2296187
  • Facility Name: WALGREENS NO 19777
  • Facility Address: 153 MAIN STREET
    OWEGO, NY
    ZIP 13827
  • Facility Phone: 607 687-0891
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. ZEIAD A. FAKHOURI
  • NPI Number: 1942725262
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 33D2296187
LAB Type Pharmacy
Facility Name WALGREENS NO 19777
Street 153 MAIN STREET
City OWEGO
State NY
ZIP 13827
Phone 607 687-0891
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