| Entity Name: | ANGEL WINGS DIAGNOSTIC LABS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Sep 2021 (3 years ago) |
| Document Number: | L21000425411 |
| FEI/EIN Number | 872880920 |
| Address: | 4330 W BROWARD BLVD, PLANTATION, FL, 33317, US |
| Mail Address: | 4351 NW 15th Street, Lauderhill, FL, 33313, US |
| ZIP code: | 33317 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346902616 | 2021-10-13 | 2021-10-13 | 4351 NW 15TH ST, LAUDERHILL, FL, 333135709, US | 4330 W BROWARD BLVD STE O, PLANTATION, FL, 333173754, US | |||||||||||||
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| Phone | +1 786-521-4206 |
Authorized person
| Name | LATRAVIA ANTINETTE CLAYTON |
| Role | OWNER/MANAGER |
| Phone | 7865214206 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CLAYTON LATRAVIA A | Agent | 4330 W BROWARD BLVD, PLANTATION, FL, 33317 |
| Name | Role | Address |
|---|---|---|
| CLAYTON LATRAVIA A | Foun | 4330 W BROWARD BLVD, PLANTATION, FL, 33317 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000150802 | ANGEL WINGS RX SOLUTIONS | ACTIVE | 2021-11-10 | 2026-12-31 | No data | 4330 W BROWARD BLVD SUITE O, PLANTATION, FL, 33317 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-04-30 | 4330 W BROWARD BLVD, SUITE O, PLANTATION, FL 33317 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-30 | 4330 W BROWARD BLVD, SUITE O, PLANTATION, FL 33317 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-30 | 4330 W BROWARD BLVD, SUITE O, PLANTATION, FL 33317 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-30 |
| ANNUAL REPORT | 2022-04-30 |
| Florida Limited Liability | 2021-09-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
