| Entity Name: | ELITE BIOMEDICAL LAB SERVICE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Feb 2019 (6 years ago) |
| Document Number: | L19000053403 |
| FEI/EIN Number | 83-3870451 |
| Address: | 15202 NW 147th Dr Suite 600, ALACHUA, FL, 32615, US |
| Mail Address: | 717 SW Howell St, Lake City, FL, 32024, US |
| ZIP code: | 32615 |
| County: | Alachua |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376116111 | 2021-07-20 | 2021-07-20 | 15202 NW 147TH DR STE 600, ALACHUA, FL, 326155333, US | 15202 NW 147TH DR STE 600, ALACHUA, FL, 326155333, US | |||||||||||||||||||||||||
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| Phone | +1 386-588-3230 |
| Fax | 8884807977 |
Authorized person
| Name | MARJILLIAN WILLIAMS |
| Role | PRESIDENT |
| Phone | 3869650313 |
Taxonomy
| Taxonomy Code | 246RP1900X - Phlebotomy Technician |
| Is Primary | Yes |
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| Is Primary | No |
Other Provider Identifiers
| Issuer | CLIA |
| Number | 10D2166575 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HARDIN MARJILLIAN L | Agent | 717 SW Howell St, Lake City, FL, 32024 |
| Name | Role | Address |
|---|---|---|
| HARDIN MARJILLIAN L | Manager | 717 SW Howell St, Lake City, FL, 32024 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000102121 | ELITE WELLNESS & LABORATORY SERVICE | ACTIVE | 2021-08-05 | 2026-12-31 | No data | 15202 NW 147TH DR SUITE 600, ALACHUA, FL, 32615 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2023-02-20 | HARDIN, MARJILLIAN L | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-04-24 | 15202 NW 147th Dr Suite 600, ALACHUA, FL 32615 | No data |
| CHANGE OF MAILING ADDRESS | 2020-04-14 | 15202 NW 147th Dr Suite 600, ALACHUA, FL 32615 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-04-14 | 717 SW Howell St, Lake City, FL 32024 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J24000255529 | ACTIVE | 1000000990017 | COLUMBIA | 2024-04-24 | 2034-05-01 | $ 4,726.02 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ALACHUA SERVICE CENTER, 14107 NW US HWY 441 STE 100, ALACHUA FL326156390 |
| J23000322685 | ACTIVE | 1000000957799 | ALACHUA | 2023-06-29 | 2033-07-12 | $ 1,621.53 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ALACHUA SERVICE CENTER, 14107 NW US HWY 441 STE 100, ALACHUA FL326156390 |
| J21000433882 | ACTIVE | 1000000899538 | ALACHUA | 2021-08-23 | 2031-08-25 | $ 2,071.03 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, ALACHUA SERVICE CENTER, 14107 NW US HWY 441 STE 100, ALACHUA FL326156390 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-30 |
| ANNUAL REPORT | 2023-02-20 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-01-12 |
| AMENDED ANNUAL REPORT | 2020-04-27 |
| ANNUAL REPORT | 2020-04-14 |
| Florida Limited Liability | 2019-02-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
