| Entity Name: | RISING TIDE REFERENCE LABORATORY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Oct 2022 (2 years ago) |
| Document Number: | L22000445289 |
| FEI/EIN Number | 884220384 |
| Address: | 495 N US HIGHWAY 17 92, UNIT 101, LONGWOOD, FL, 32750, US |
| Mail Address: | 495 N US HIGHWAY 17 92, UNIT 101, LONGWOOD, FL, 32750, US |
| ZIP code: | 32750 |
| County: | Seminole |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669170882 | 2023-02-16 | 2024-04-17 | 495 N HWY 17 92 UNIT 101, LONGWOOD, FL, 327504487, US | 495 N HWY 17 92 UNIT 101, LONGWOOD, FL, 327504487, US | |||||||||||||||
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| Phone | +1 407-476-1646 |
| Fax | 3522823975 |
Authorized person
| Name | MR. ERNEST BURDETT FISHER |
| Role | CEO |
| Phone | 4074763667 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JONES SKILES K | Agent | 871 OUTER RD, ORLANDO, FL, 32814 |
| Name | Role | Address |
|---|---|---|
| Hrush Jeffrey D | Owne | 610 Trails End Rd, Wilmington, NC, 28409 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-09-13 | 495 N US HIGHWAY 17 92, UNIT 101, LONGWOOD, FL 32750 | No data |
| CHANGE OF MAILING ADDRESS | 2023-09-13 | 495 N US HIGHWAY 17 92, UNIT 101, LONGWOOD, FL 32750 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-06 |
| ANNUAL REPORT | 2024-01-24 |
| AMENDED ANNUAL REPORT | 2023-09-13 |
| ANNUAL REPORT | 2023-01-27 |
| Florida Limited Liability | 2022-10-17 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
