| Entity Name: | EXCELLENCE MEDICAL LABS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 14 Oct 2022 (2 years ago) |
| Document Number: | L22000444468 |
| FEI/EIN Number | 92-0776793 |
| Address: | 1301 BEVILLE RD, STE 10, DAYTONA BEACH, FL 32119 |
| Mail Address: | 1301 BEVILLE RD, UNIT 11, DAYTONA BEACH, FL 32119 |
| ZIP code: | 32119 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952007874 | 2023-02-02 | 2023-02-02 | 1301 BEVILLE RD, UNIT 8, DAYTONA BEACH, FL, 321191503, US | 1301 BEVILLE RD, UNIT 8, DAYTONA BEACH, FL, 321191503, US | |||||||||||||||
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| Phone | +1 386-238-9064 |
| Fax | 3862389063 |
Authorized person
| Name | HUSAM EDDIN |
| Role | OWNER |
| Phone | 3862389064 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| EDDIN, HUSAM | Agent | 1301 BEVILLE RD, UNIT 8, DAYTONA BEACH, FL 32119 |
| Name | Role | Address |
|---|---|---|
| McDavid, Kelly | Practice Manager | 1301 BEVILLE RD, UNIT 11 DAYTONA BEACH, FL 32119 |
| Name | Role | Address |
|---|---|---|
| Eddin, Husam | Owner | 1301 BEVILLE RD, UNIT 8 DAYTONA BEACH, FL 32119 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000070674 | EXCELLENCE HEALTH MEDICAL CLINICS | ACTIVE | 2024-06-06 | 2029-12-31 | No data | 1301 BEVILLE RD STE 8&9, DAYTONA BEACH, FL, 32119 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-06-07 | 1301 BEVILLE RD, STE 10, DAYTONA BEACH, FL 32119 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-08 | 1301 BEVILLE RD, STE 10, DAYTONA BEACH, FL 32119 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-06-07 |
| AMENDED ANNUAL REPORT | 2024-04-08 |
| AMENDED ANNUAL REPORT | 2024-04-05 |
| ANNUAL REPORT | 2024-02-08 |
| ANNUAL REPORT | 2023-02-03 |
| Florida Limited Liability | 2022-10-14 |
Date of last update: 11 Jan 2025
Sources: Florida Department of State
