| Name: | Colbert Laboratory, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 11 Jun 1992 (32 years ago) (Companies founded in June 1992) |
| Date of dissolution: | 03 Jan 2012 |
| Entity Number: | 000-150-212 |
| Register Number: | 000150212 |
| ZIP code: | 35653 (Companies in Franklin, 35653) |
| County: | Franklin |
| Place of Formation: | Colbert County |
| Principal Address: | RUSSELLVILLE, AL |
| Registered Office Street Address: | 128 GUARD STREETRUSSELLVILLE, AL 35653 |
| Authorized Capital: | 1000 NPV |
Activities
MEDICAL TESTING
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1063406320 | 2005-09-01 | 2007-08-01 | PO BOX 547, RUSSELLVILLE, AL, 356530547, US | 128 GUARD ST, RUSSELLVILLE, AL, 35653, US | |||||||||||||||||||||||||
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| Phone | +1 256-332-6602 |
| Fax | 2563326690 |
Authorized person
| Name | MR. GARY L BRILES |
| Role | ADMINISTRATOR |
| Phone | 2563326602 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | 09778 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 57244 |
| State | AL |
| Name | Role |
|---|---|
| BRILES, GARY L | Agent |
| Name | Role |
|---|---|
| TOMLINSON, JERRY A | Incorporator |
| BRILES, GARY L | Incorporator |
| KIMBROUGH, DAVID R | Incorporator |
| VANCE, DAVID A | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
