Diagnostic Clinic, P.C.

Details

Name:	Diagnostic Clinic, P.C.
Jurisdiction:	Alabama
Legal type:	Domestic Professional Corporation
Status:	Exists
Date of registration:	21 Oct 1991 (33 years ago)
Entity Number:	000-145-805
Register Number:	000145805
County:	Madison
Place of Formation:	Madison County
Principal Address:	HUNTSVILLE, AL
Registered Office Street Address:	250 CHATEAU STE 205HUNTSVILLE, AL 35801
Registered Office Street Address ZIP Code:	35801
Authorized Capital:	$1,000

Activities PROVIDE MEDICAL SERVICE

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1104993526

2006-11-29

2007-10-24

185 WHITESPORT DR SW, SUITE 1, HUNTSVILLE, AL, 358016486, US

Contacts

Phone	+1 256-880-8828
Fax	2568808756

Authorized person

Name	JUDY A VANCLEAVE
Role	OFFICE MGR.
Phone	2568808828

Taxonomy

Taxonomy Code	261Q00000X - Clinic/Center
License Number	14493
State	AL
Is Primary	Yes

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

DIAGNOSTIC CLINIC P C 401K PLAN AND TRUST

2021

631053691

2022-01-25

DIAGNOSTIC CLINIC P C

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	621111
Sponsor’s telephone number	2568808828
Plan sponsor’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801

Signature of

Role	Plan administrator
Date	2022-01-25
Name of individual signing	RAO CHIMATA

DIAGNOSTIC CLINIC P C 401K PLAN AND TRUST

2020

631053691

2021-10-08

DIAGNOSTIC CLINIC P C

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	621111
Sponsor’s telephone number	2568808828
Plan sponsor’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801

Signature of

Role	Plan administrator
Date	2021-10-08
Name of individual signing	RAO CHIMATA

DIAGNOSTIC CLINIC P C 401K PLAN AND TRUST

2019

631053691

2020-10-07

DIAGNOSTIC CLINIC P C

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	621111
Sponsor’s telephone number	2568808828
Plan sponsor’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801

Signature of

Role	Plan administrator
Date	2020-10-07
Name of individual signing	RAO CHIMATA

DIAGNOSTIC CLINIC P C 401K PLAN AND TRUST

2018

631053691

2019-10-11

DIAGNOSTIC CLINIC P C

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	621111
Sponsor’s telephone number	2568808828
Plan sponsor’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801

Signature of

Role	Plan administrator
Date	2019-10-11
Name of individual signing	RAO CHIMATA

DIAGNOSTIC CLINIC P C 401K PLAN AND TRUST

2017

631053691

2018-10-15

DIAGNOSTIC CLINIC P C

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	621111
Sponsor’s telephone number	2568808828
Plan sponsor’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801

Signature of

Role	Plan administrator
Date	2018-10-15
Name of individual signing	RAO CHIMATA

DIAGNOSTIC CLINIC P C 401K PLAN AND TRUST

2016

631053691

2017-09-27

DIAGNOSTIC CLINIC P C

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	621111
Sponsor’s telephone number	2568808828
Plan sponsor’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801

Signature of

Role	Plan administrator
Date	2017-09-27
Name of individual signing	RAO CHIMATA

DIAGNOSTIC CLINIC P C 401K PLAN AND TRUST

2015

631053691

2016-09-26

DIAGNOSTIC CLINIC P C

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	621111
Sponsor’s telephone number	2568808828
Plan sponsor’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801

Signature of

Role	Plan administrator
Date	2016-09-26
Name of individual signing	RAO CHIMATA

DIAGNOSTIC CLINIC P C 401K PLAN AND TRUST

2014

631053691

2015-10-06

DIAGNOSTIC CLINIC P C

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	621111
Sponsor’s telephone number	2568808828
Plan sponsor’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801

Signature of

Role	Plan administrator
Date	2015-10-06
Name of individual signing	RAO CHIMATA

DIAGNOSTIC CLINIC P C 401K PLAN AND TRUST

2013

631053691

2014-09-29

DIAGNOSTIC CLINIC P C

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	621111
Sponsor’s telephone number	2568808828
Plan sponsor’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801

Signature of

Role	Plan administrator
Date	2014-09-29
Name of individual signing	RAO CHIMATA

DIAGNOSTIC CLINIC P C 401K PLAN AND TRUST

2012

631053691

2013-10-04

DIAGNOSTIC CLINIC P C

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2005-01-01
Business code	621111
Sponsor’s telephone number	2568808828
Plan sponsor’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801

Plan administrator’s name and address

Administrator’s EIN	631053691
Plan administrator’s name	DIAGNOSTIC CLINIC P C
Plan administrator’s address	185 WHITE SPORT SUITE 1, HUNTSVILLE, AL, 35801
Administrator’s telephone number	2568808828

Signature of

Role	Plan administrator
Date	2013-10-04
Name of individual signing	RAO CHIMATA

Agent

Name	Role
CHIMATA, RAO C MD	Agent

Incorporator

Name	Role
CHIMATA, RAO C MD	Incorporator

Events

Event Date	Event Type	Old Value	New Value
1991-12-02	Name Merged	No data	RAO C. CHIMATA, M.D., P.C. (LA-NQ) Non-Qualified Foreign Into Domestic

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

Diagnostic Clinic, P.C.

Details

National Provider Identifier

form 5500

Agent

Incorporator

Events

Related by officers

Related by address