Provider Demographics
NPI:1093457939
Name:FORWARD PATH DX LAB LLC
Entity type:Organization
Organization Name:FORWARD PATH DX LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANG
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-787-6623
Mailing Address - Street 1:5431 BARKER CYPRESS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1994
Mailing Address - Country:US
Mailing Address - Phone:281-787-6623
Mailing Address - Fax:888-624-3596
Practice Address - Street 1:5431 BARKER CYPRESS RD STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1994
Practice Address - Country:US
Practice Address - Phone:888-624-3596
Practice Address - Fax:888-624-3596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D2257515OtherCLIA