| Entity Name: | CRONOS CLINICAL LABORATORY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 23 Apr 2004 (21 years ago) |
| Document Number: | P04000067476 |
| FEI/EIN Number | 54-2150800 |
| Address: | 2650 NW 97TH AVENUE, MIAMI, FL 33172 |
| Mail Address: | 2650 NW 97TH AVENUE, MIAMI, FL 33172 |
| ZIP code: | 33172 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982604070 | 2005-07-29 | 2020-08-20 | 2650 NW 97TH AVE, DORAL, FL, 331721400, US | 2650 NW 97TH AVE, DORAL, FL, 331721400, US | |||||||||||||||||||||||||
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| Phone | +1 305-592-2503 |
| Fax | 3055922663 |
Authorized person
| Name | ERNESTO CHAO |
| Role | PRESIDENT |
| Phone | 3055922503 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 800019596 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 031396300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CHAO, ERNESTO | Agent | 2650 NW 97TH AVENUE, MIAMI, FL 33172 |
| Name | Role | Address |
|---|---|---|
| GONZALEZ, MAIKEL | Vice President | 2650 NW 97TH AVENUE, MIAMI, FL 33172 |
| Name | Role | Address |
|---|---|---|
| CHAO, ERNESTO | President | 2650 NW 97 AVE, MIAMI, FL 33172 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2011-01-21 | 2650 NW 97TH AVENUE, MIAMI, FL 33172 | No data |
| CHANGE OF MAILING ADDRESS | 2011-01-21 | 2650 NW 97TH AVENUE, MIAMI, FL 33172 | No data |
| REGISTERED AGENT NAME CHANGED | 2006-08-04 | CHAO, ERNESTO | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-06 |
| ANNUAL REPORT | 2024-03-18 |
| ANNUAL REPORT | 2023-03-01 |
| ANNUAL REPORT | 2022-03-17 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-06-17 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-04-25 |
| ANNUAL REPORT | 2017-03-16 |
| ANNUAL REPORT | 2016-03-29 |
Date of last update: 29 Jan 2025
Sources: Florida Department of State
