| Entity Name: | TOMOKA MEDICAL LAB, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 14 Jul 1989 (36 years ago) |
| Document Number: | L02016 |
| FEI/EIN Number | 592962543 |
| Address: | 783 S. NOVA RD., ORMOND BEACH, FL, 32174 |
| Mail Address: | 783 S. NOVA RD., ORMOND BEACH, FL, 32174 |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700819794 | 2006-07-10 | 2020-08-22 | 783 S NOVA RD, ORMOND BEACH, FL, 321747332, US | 783 S NOVA RD, ORMOND BEACH, FL, 321747332, US | |||||||||||||||||
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| Phone | +1 386-677-8014 |
| Fax | 3866738401 |
Authorized person
| Name | MR. MOHAMED SALEH SABOUNJI |
| Role | MEDICAL TECHNOLOGIST |
| Phone | 3866778014 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SABOUNGI HASSAN | Agent | 1570 JOHN ANDERSON DR, ORMOND BEACH, FL, 32176 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR REGISTERED AGENT | 2020-05-06 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J21000585574 | ACTIVE | 20-090-D4 | LEON | 2021-08-25 | 2026-11-15 | $8,377.36 | DFS DIVISION OF WORKERS COMPENSATION, 200 EAST GAINES STREET, TALLAHASSEE, FL 32399-4228 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
