| Name: | Proteus Molecular and Clinical Lab LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 25 Jun 2015 (10 years ago) |
| Entity Number: | 000-338-876 |
| Register Number: | 000338876 |
| ZIP code: | 35209 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 218 SUMMIT PKWYHOMEWOOD, AL 35209 |
Activities
SALE AND DISTRIBUTION OF MEDICAL TESTING SERVICES
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | Proteus Molecular and Clinical Lab LLC, MISSISSIPPI | 1104998 | MISSISSIPPI |
| Headquarter of | Proteus Molecular and Clinical Lab LLC, FLORIDA | M16000009002 | FLORIDA |
| Headquarter of | Proteus Molecular and Clinical Lab LLC, COLORADO | 20191270341 | COLORADO |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538542196 | 2015-07-01 | 2018-06-18 | 218 SUMMIT PKWY, SUITE 250, HOMEWOOD, AL, 352094732, US | 218 SUMMIT PKWY, SUITE 250, HOMEWOOD, AL, 35209, US | |||||||||||||||||||||
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| Phone | +1 205-820-0115 |
Authorized person
| Name | MICHAEL A GRIFFITH |
| Role | MEMBER MANAGER |
| Phone | 2058200115 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 198878 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PROTEUS 401(K) PLAN | 2023 | 474299310 | 2024-07-19 | PROTEUS MOLECULAR AND CLINICAL LAB LLC | 46 | |||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-19 |
| Name of individual signing | CAITLYN BELLENGER |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 541700 |
| Sponsor’s telephone number | 2058020115 |
| Plan sponsor’s address | 218 SUMMIT PARKWAY, HOMEWOOD, AL, 35209 |
Signature of
| Role | Plan administrator |
| Date | 2023-06-26 |
| Name of individual signing | CAITLYN BELLENGER |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 541700 |
| Sponsor’s telephone number | 2058020115 |
| Plan sponsor’s address | 218 SUMMIT PARKWAY, HOMEWOOD, AL, 35209 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-17 |
| Name of individual signing | CAITLYN BELLENGER |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 541700 |
| Sponsor’s telephone number | 2058020115 |
| Plan sponsor’s address | 218 SUMMIT PARKWAY, SUITE 250, HOMEWOOD, AL, 35209 |
Signature of
| Role | Plan administrator |
| Date | 2022-07-18 |
| Name of individual signing | CAITLYN BELLENGER |
| Name | Role | Address |
|---|---|---|
| GREEN, WILLIAM G | Agent | 2610 STONY BRANCH RDBIRMINGHAM, AL 35243 |
| Name | Role | Address |
|---|---|---|
| GREEN, WILLIAM G | Organizer | 2610 STONY BRANCH RDBIRMINGHAM, AL 35243 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
