| Entity Name: | NORTH CAUSEWAY MEDICAL LABORATORY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 08 Nov 2010 (14 years ago) |
| Date of dissolution: | 25 Sep 2015 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2015 (9 years ago) |
| Document Number: | L10000116147 |
| FEI/EIN Number | 273573662 |
| Address: | 161 NORTH CAUSEWAY, NEW SMYRNA BEACH, FL, 32169, US |
| Mail Address: | 161 NORTH CAUSEWAY, SUITE D, NEW SMYRNA BEACH, FL, 32169, US |
| ZIP code: | 32169 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184905747 | 2011-09-08 | 2011-09-08 | 161 N CAUSEWAY, SUITE D, NEW SMYRNA BEACH, FL, 321695303, US | 161 N CAUSEWAY, SUITE D, NEW SMYRNA BEACH, FL, 321695303, US | |||||||||||||||||||
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| Phone | +1 386-957-3815 |
| Fax | 3864286696 |
Authorized person
| Name | DR. MARK A. KUCKER |
| Role | LAB DIRECTOR |
| Phone | 3869573815 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 800026144 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| KUCKER MARK A | Agent | 161 NORTH CAUSEWAY, NEW SMYRNA BEACH, FL, 32169 |
| Name | Role | Address |
|---|---|---|
| KUCKER MARK A | Managing Member | 161 NORTH CAUSEWAY SUITE D, NEW SMYRNA BEACH, FL, 32169 |
| LIU WING YI | Managing Member | 161 NORTH CAUSEWAY SUITE C, NEW SMYRNA BEACH, FL, 32169 |
| YEE JOHN | Managing Member | 161 NORTH CAUSEWAY SUITE A, NEW SMYRNA BEACH, FL, 32169 |
| APPLETON STACI | Managing Member | 161 NORTH CAUSEWAY, NEW SMYRNA BEACH, FL, 32169 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-29 | 161 NORTH CAUSEWAY, SUITE D, NEW SMYRNA BEACH, FL 32169 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2014-02-06 |
| ANNUAL REPORT | 2013-02-19 |
| ANNUAL REPORT | 2012-02-07 |
| ANNUAL REPORT | 2011-04-29 |
| Florida Limited Liability | 2010-11-08 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
