| Entity Name: | GAMMA DIAGNOSTIC LAB, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Jun 2019 (6 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 03 Dec 2021 (3 years ago) |
| Document Number: | L19000161932 |
| FEI/EIN Number | 84-2269446 |
| Address: | 2662 NW 97th Ave, Doral, FL, 33172, US |
| Mail Address: | 2662 NW 97th Ave, Doral, FL, 33172, US |
| ZIP code: | 33172 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780219576 | 2020-03-11 | 2020-03-11 | 2662 NW 97TH AVE, DORAL, FL, 331721400, US | 2662 NW 97TH AVE, DORAL, FL, 331721400, US | |||||||||||||||||||||
|
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| Phone | +1 786-310-7595 |
| Fax | 7862009120 |
Authorized person
| Name | CARLOS LOPEZ |
| Role | CFO |
| Phone | 7863107595 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CLIA |
| Number | 10D2178495 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LOPEZ CARLOS A | Agent | 2662 NW 97th Ave, Doral, FL, 33172 |
| Name | Role | Address |
|---|---|---|
| LOPEZ CARLOS A | Chief Financial Officer | 2662 NW 97th Ave, Doral, FL, 33172 |
| Name | Role | Address |
|---|---|---|
| LINARES JESUS | Manager | 2662 NW 97TH AVE, DORAL, FL, 33172 |
| GUERRA MIGUEL | Manager | 2662 NW 97TH AVE, DORAL, FL, 33172 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2021-12-03 | No data | No data |
| LC AMENDMENT | 2021-11-01 | No data | No data |
| LC AMENDMENT | 2020-03-11 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-01-15 | 2662 NW 97th Ave, Doral, FL 33172 | No data |
| CHANGE OF MAILING ADDRESS | 2020-01-15 | 2662 NW 97th Ave, Doral, FL 33172 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-01-15 | 2662 NW 97th Ave, Doral, FL 33172 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-21 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-04-19 |
| LC Amendment | 2021-12-03 |
| LC Amendment | 2021-11-01 |
| ANNUAL REPORT | 2021-04-07 |
| LC Amendment | 2020-03-11 |
| ANNUAL REPORT | 2020-01-15 |
| Florida Limited Liability | 2019-06-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
