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DermLab, LLC

Details

Name: DermLab, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 06 Dec 2012 (12 years ago)
Entity Number: 000-055-559
Register Number: 000055559
County: Jefferson
Place of Formation: Jefferson County
Registered Office Street Address: 1613 CHATEAU CREST LANEBIRMINGHAM, AL 35216
Registered Office Street Address ZIP Code: 35216

Activities PRACTICE OF MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1164764528 2013-03-25 2013-03-25 3918 MONTCLAIR RD, SUITE 105, MOUNTAIN BRK, AL, 352132425, US 3918 MONTCLAIR RD, SUITE 105, MOUNTAIN BRK, AL, 352132425, US

Contacts
Phone +1 205-705-3550
Fax 2057053554

Authorized person
Name CHARLES A PARRISH
Role MANAGER
Phone 2055668047

Taxonomy
Taxonomy Code 207ZD0900X - Dermatopathology (Pathology) Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DERMLAB, LLC 401(K) PROFIT SHARING PLAN 2023 461521728 2024-10-15 DERMLAB, LLC 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621510
Sponsor’s telephone number 2057053550
Plan sponsor’s address 3918 MONTCLAIR ROAD, SUITE 105, BIRMINGHAM, AL, 35213

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing LEE ANN WEBSTER
Valid signature Filed with authorized/valid electronic signature
DERMLAB, LLC 401(K) PROFIT SHARING PLAN 2023 461521728 2024-10-15 DERMLAB, LLC 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621510
Sponsor’s telephone number 2057053550
Plan sponsor’s address 3918 MONTCLAIR ROAD, SUITE 105, BIRMINGHAM, AL, 35213

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing LEE ANN WEBSTER
Valid signature Filed with authorized/valid electronic signature
DERMLAB, LLC 401(K) PROFIT SHARING PLAN 2022 461521728 2023-10-12 DERMLAB, LLC 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621510
Sponsor’s telephone number 2057053550
Plan sponsor’s address 3918 MONTCLAIR ROAD, SUITE 105, BIRMINGHAM, AL, 35213

Signature of
Role Plan administrator
Date 2023-10-12
Name of individual signing LEE ANN WEBSTER
DERMLAB, LLC 401(K) PROFIT SHARING PLAN 2021 461521728 2022-07-29 DERMLAB, LLC 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621510
Sponsor’s telephone number 2057053550
Plan sponsor’s address 3918 MONTCLAIR ROAD, SUITE 105, BIRMINGHAM, AL, 35213

Signature of
Role Plan administrator
Date 2022-07-29
Name of individual signing LEE ANN WEBSTER
DERMLAB, LLC 401(K) PROFIT SHARING PLAN 2020 461521728 2021-07-26 DERMLAB, LLC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621510
Sponsor’s telephone number 2057053550
Plan sponsor’s address 3918 MONTCLAIR ROAD, SUITE 105, BIRMINGHAM, AL, 35213

Signature of
Role Plan administrator
Date 2021-07-26
Name of individual signing LEE ANN WEBSTER
DERMLAB, LLC 401(K) PROFIT SHARING PLAN 2019 461521728 2020-10-14 DERMLAB, LLC 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621510
Sponsor’s telephone number 2057053550
Plan sponsor’s address 3918 MONTCLAIR ROAD, SUITE 105, BIRMINGHAM, AL, 35213

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing LEE ANN WEBSTER
DERMLAB, LLC 401(K) PROFIT SHARING PLAN 2018 461521728 2019-07-23 DERMLAB, LLC 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621510
Sponsor’s telephone number 2057053550
Plan sponsor’s address 3918 MONTCLAIR ROAD, SUITE 105, BIRMINGHAM, AL, 35213

Signature of
Role Plan administrator
Date 2019-07-23
Name of individual signing MICHAEL K. JACOBS, MD
DERMLAB, LLC 401(K) PROFIT SHARING PLAN 2017 461521728 2018-07-31 DERMLAB, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621510
Sponsor’s telephone number 2057053550
Plan sponsor’s address 3918 MONTCLAIR ROAD, SUITE 105, BIRMINGHAM, AL, 35213
DERMLAB, LLC 401(K) PROFIT SHARING PLAN 2016 461521728 2017-07-28 DERMLAB, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621510
Sponsor’s telephone number 2057053550
Plan sponsor’s address 3918 MONTCLAIR ROAD, SUITE 105, BIRMINGHAM, AL, 35213

Signature of
Role Plan administrator
Date 2017-07-28
Name of individual signing CASEY SORRELL
DERMLAB, LLC 401(K) PROFIT SHARING PLAN 2015 461521728 2016-07-28 DERMLAB, LLC 15
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621510
Sponsor’s telephone number 2057053550
Plan sponsor’s address 39158 MONTCLAIR ROAD, SUITE 105, BIRMINGHAM, AL, 35213

Signature of
Role Plan administrator
Date 2016-07-28
Name of individual signing MICHAEL K. JACOBS, MD

Agent

Name Role Address
MASON, STEPHEN Agent 1613 CHATEAU CREST LANEBIRMINGHAM, AL 35216

Organizer

Name Role Address
JACOBS, MICHAEL Organizer 600 CONROY LNSTERRETT, AL 35147
MASON, STEPHEN Organizer 1613 CHATEAU CREST LANEBIRMINGHAM, AL 35216
PARRISH, CHARLES Organizer 3021 CAMBRIDGE ROADBIRMINGHAM, AL 35223
MARK, LADD W Organizer 420 NORTH 20TH STREET SUITE 3400BIRMINGHAM, AL 35203

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Related by address

No related companies by address

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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