| Entity Name: | ST. JOHNS BIOMEDICAL LABORATORIES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
ST. JOHNS BIOMEDICAL LABORATORIES, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 16 Oct 1989 (36 years ago) |
| Document Number: | L23505 |
| FEI/EIN Number |
592974661
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 165 SOUTH PARK BLVD STE A, ST AUGUSTINE, FL, 32086, US |
| Mail Address: | 165 SOUTH PARK BLVD STE A, ST AUGUSTINE, FL, 32086, US |
| ZIP code: | 32086 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821001330 | 2006-08-14 | 2008-06-17 | PO BOX 860206, 165 SOUTHPARK BLVD, ST. AUGUSTINE, FL, 320860206, US | 165 SOUTHPARK BLVD, SUITE A, ST AUGUSTINE, FL, 320864101, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-824-5497 |
| Fax | 9048248257 |
Authorized person
| Name | EDWIN OLIVA SIA |
| Role | DIRECTOR/OWNER |
| Phone | 9048245497 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 800001722 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | CLIA |
| Number | 10D0645082 |
| State | FL |
| Issuer | CLINICAL LAB LICENSE |
| Number | 800001722 |
| State | FL |
| Issuer | MEDICAID |
| Number | 030142600 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ST JOHNS BIOMEDICAL LABORATORIES PROFIT SHARING PLAN | 2012 | 592974661 | 2013-09-24 | ST JOHNS BIOMEDICAL LABORATORIES INC | 5 | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 592974661 |
| Plan administrator’s name | EDWIN O SIA |
| Plan administrator’s address | PO BOX 860206, JACKSONVILLE, FL, 32086 |
| Administrator’s telephone number | 9048245497 |
Number of participants as of the end of the plan year
| Active participants | 5 |
| Other retired or separated participants entitled to future benefits | 2 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2013-09-24 |
| Name of individual signing | EDWIN SIA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2013-09-24 |
| Name of individual signing | EDWIN SIA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1992-01-01 |
| Business code | 621510 |
| Plan sponsor’s DBA name | ST JOHNS BIOMEDICAL LABORATORIES INC |
| Plan sponsor’s mailing address | PO BOX 860206, ST AUGUSTINE, FL, 32086 |
| Plan sponsor’s address | 165 SOUTHPARK BLVD, ST AUGUSTINE, FL, 32086 |
Plan administrator’s name and address
| Administrator’s EIN | 592974661 |
| Plan administrator’s name | ST JOHNS BIOMEDICAL LABORATORIES INC |
| Plan administrator’s address | PO BOX 860206, ST AUGUSTINE, FL, 32086 |
Number of participants as of the end of the plan year
| Active participants | 5 |
| Other retired or separated participants entitled to future benefits | 2 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-31 |
| Name of individual signing | EDWIN SIA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1992-01-01 |
| Business code | 621510 |
| Sponsor’s telephone number | 9048245497 |
| Plan sponsor’s DBA name | ST JOHNS BIOMEDICAL LABORATORIES INC |
| Plan sponsor’s mailing address | PO BOX 860206, ST AUGUSTINE, FL, 32086 |
| Plan sponsor’s address | 165 SOUTHPARK BLVD SUITE A, ST AUGUSTINE, FL, 32086 |
Plan administrator’s name and address
| Administrator’s EIN | 592974661 |
| Plan administrator’s name | ST JOHNS BIOMEDICAL LABORATORIES INC |
| Plan administrator’s address | PO BOX 860206, ST AUGUSTINE, FL, 32086 |
| Administrator’s telephone number | 9048245497 |
Number of participants as of the end of the plan year
| Active participants | 5 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 1 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 0 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-13 |
| Name of individual signing | EDWIN SIA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Sia Edwin ODr. | Agent | 165 SOUTH PARK BLVD STE A, ST AUGUSTINE, FL, 32086 |
| SIA, EDWIN O. | President | 165 SOUTH PARK BLVD STE A, ST AUGUSTINE, FL, 32086 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2014-03-03 | 165 SOUTH PARK BLVD STE A, ST AUGUSTINE, FL 32086 | - |
| REGISTERED AGENT NAME CHANGED | 2014-03-03 | Sia, Edwin O, Dr. | - |
| REGISTERED AGENT ADDRESS CHANGED | 2014-03-03 | 165 SOUTH PARK BLVD STE A, ST AUGUSTINE, FL 32086 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2013-01-21 | 165 SOUTH PARK BLVD STE A, ST AUGUSTINE, FL 32086 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-29 |
| ANNUAL REPORT | 2024-03-05 |
| ANNUAL REPORT | 2023-04-22 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-03-17 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-02-01 |
| ANNUAL REPORT | 2017-01-09 |
| ANNUAL REPORT | 2016-01-22 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2421928700 | 2021-03-29 | 0491 | PPS | 165 Southpark Blvd Ste A, St Augustine, FL, 32086-4121 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8205977308 | 2020-05-01 | 0491 | PPP | 165 SOUTHPARK BLVD STE A, ST AUGUSTINE, FL, 32086-4121 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Apr 2025
Sources: Florida Department of State
