MEDICARE: VENTURE DX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1063376655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VENTURE DX LLC

Provider Business Mailing Address
First Line	:	915 PINON RANCH VW STE 3
Second Line	:
City	:	COLORADO SPGS
State	:	CO
Zip	:	80907-3578
Country	:	US
Telephone Number	:	719-309-5362
Fax Number	:	720-358-0164

Provider Business Practice Location Address
First Line	:	915 PINON RANCH VW STE 3
Second Line	:
City	:	COLORADO SPGS
State	:	CO
Zip	:	80907-3578
Country	:	US
Telephone Number	:	719-309-5362
Fax Number	:	720-358-0164

Authorized Official
Title or Position	:	OWNER
Name	:	SYED WAJAHAT
Credential	:	OWNER
Telephone Number	:	719-309-5362

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “VENTURE DX LLC ” Practice Location

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