| Entity Name: | MEDICAL DNA LABS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 22 Apr 2014 (11 years ago) |
| Document Number: | L14000065824 |
| FEI/EIN Number | 46-5553897 |
| Address: | 501 N. REO STREET, TAMPA, FL 33609 |
| Mail Address: | 501 N. REO STREET, TAMPA, FL 33609 |
| ZIP code: | 33609 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821409756 | 2014-05-14 | 2022-08-07 | PO BOX 205213, DALLAS, TX, 753205213, US | 3450 E FLETCHER AVE STE 230A, TAMPA, FL, 336134600, US | |||||||||||||||||||
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| Phone | +1 813-769-8810 |
Authorized person
| Name | JOSHUA HELMS |
| Role | CHIEF OPERATING OFFICER |
| Phone | 8135492134 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 104904500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Wood, David | Agent | 504 N. REO STREET, TAMPA, FL 33609 |
| Name | Role | Address |
|---|---|---|
| Helms, Josh | Chief Executive Officer | 504 N. REO STREET, TAMPA, FL 33609 |
| Name | Role | Address |
|---|---|---|
| Gari, Tracie | Chief Administrative Officer | 504 N. REO STREET, TAMPA, FL 33609 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000070116 | NEW GEN LABS | EXPIRED | 2017-06-27 | 2022-12-31 | No data | 4730 N. HABANA AVE. SUITE 204, TAMPA, FL, 33614 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-05-24 | 501 N. REO STREET, TAMPA, FL 33609 | No data |
| CHANGE OF MAILING ADDRESS | 2023-05-24 | 501 N. REO STREET, TAMPA, FL 33609 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-03-14 | Wood, David | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-26 | 504 N. REO STREET, TAMPA, FL 33609 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-03-14 |
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-03-12 |
| ANNUAL REPORT | 2020-06-26 |
| ANNUAL REPORT | 2019-04-07 |
| ANNUAL REPORT | 2018-04-22 |
| ANNUAL REPORT | 2017-02-20 |
| ANNUAL REPORT | 2016-04-08 |
| ANNUAL REPORT | 2015-04-09 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
