MEDICARE: SYNEXIS LAB AND DIAGNOSTICS 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	:	1750208740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNEXIS LAB AND DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	7685 103RD ST STE 200
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-9325
Country	:	US
Telephone Number	:	314-629-5794
Fax Number	:

Provider Business Practice Location Address
First Line	:	7685 103RD ST STE 200
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-9325
Country	:	US
Telephone Number	:	314-629-5794
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FAROOQ AMIN BAJWA
Credential	:
Telephone Number	:	330-382-4238

Provider Enumeration Date	:	07/01/2026
Last Update Date	:	07/01/2026

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