MEDICARE: NEXIGENYX 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	:	1780516039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEXIGENYX DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	8200 WEDNESBURY LN STE 496
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-2925
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8200 WEDNESBURY LN STE 496
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-2925
Country	:	US
Telephone Number	:	346-899-3363
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ZELIMKHAN KERCHIEV
Credential	:
Telephone Number	:	346-899-3363

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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