| Entity Name: | MICRO PATH LABORATORIES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 24 Dec 1991 (33 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 22 Jun 2004 (21 years ago) |
| Document Number: | V02889 |
| FEI/EIN Number | 59-3097649 |
| Address: | 1125 BARTOW RD, STE 101, LAKELAND, FL 33801 |
| Mail Address: | 1125 BARTOW RD, STE 101, LAKELAND, FL 33801 |
| ZIP code: | 33801 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932159118 | 2006-05-11 | 2016-02-02 | 1125 BARTOW RD, SUITE 101, LAKELAND, FL, 338015852, US | 1125 BARTOW RD, SUITE 101, LAKELAND, FL, 338015852, US | |||||||||||||||||||||||||||||||
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| Phone | +1 863-683-7171 |
| Fax | 8636870742 |
Authorized person
| Name | DR. CRAIG D LARISCY |
| Role | PRESIDENT |
| Phone | 8636837171 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 800000683 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 030551100 |
| State | FL |
| Issuer | MEDICARE PTAN |
| Number | L8179 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LARISCY, CRAIG DMD | Agent | 1125 BARTOW RD, STE 101, LAKELAND, FL 33801 |
| Name | Role | Address |
|---|---|---|
| LARISCY, CRAIG D, Dr. | Vice President | 1125 BARTOW RD, STE 101 LAKELAND, FL 33801 |
| BOYNTON, EVANDER A, Dr. | Vice President | 1125 BARTOW RD, STE 101 LAKELAND, FL 33801 |
| Name | Role | Address |
|---|---|---|
| GARCIA, EDWARD J, Dr. | Treasurer | 1125 BARTOW RD, STE 101 LAKELAND, FL 33801 |
| Name | Role | Address |
|---|---|---|
| YODER, BRIAN J, Dr. | President | 1125 BARTOW RD, STE 101, LAKELAND, FL 33801 |
| Name | Role | Address |
|---|---|---|
| DICKASON, TIMOTHY J, Dr. | Secretary | 1125 BARTOW RD, STE 101 LAKELAND, FL 33801 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000029295 | PATHOLOGY SERVICES | ACTIVE | 2017-03-20 | 2027-12-31 | No data | 1125 BARTOW RD., SUITE 101, LAKELAND, FL, 33801 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2008-10-16 | 1125 BARTOW RD, STE 101, LAKELAND, FL 33801 | No data |
| CHANGE OF MAILING ADDRESS | 2008-10-16 | 1125 BARTOW RD, STE 101, LAKELAND, FL 33801 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-10-16 | 1125 BARTOW RD, STE 101, LAKELAND, FL 33801 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-01-10 | LARISCY, CRAIG DMD | No data |
| AMENDMENT | 2004-06-22 | No data | No data |
| MERGER | 1999-03-23 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 700000022267 |
| NAME CHANGE AMENDMENT | 1997-08-29 | MICRO PATH LABORATORIES, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-27 |
| ANNUAL REPORT | 2024-01-29 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-10 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-03-29 |
| ANNUAL REPORT | 2017-03-21 |
| ANNUAL REPORT | 2016-04-20 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
