Lexington Clinic, Inc.

Details

Name:	Lexington Clinic, Inc.
Jurisdiction:	Alabama
Legal type:	Domestic Corporation
Status:	Dissolved
Date of registration:	11 May 2004 (21 years ago)
Date of dissolution:	21 Dec 2015
Entity Number:	000-235-166
Register Number:	000235166
County:	Lauderdale
Place of Formation:	Lauderdale County
Principal Address:	FLORENCE, AL
Registered Office Street Address:	1604-A MOCKINGBIRD CTFLORENCE, AL 35630
Registered Office Street Address ZIP Code:	35630
Authorized Capital:	$1,000
Paid Share Capital:	$1,000

Activities MEDICAL CLINIC

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1497819734

2006-12-21

2020-08-22

11631 HIGHWAY 101, LEXINGTON, AL, 356483249, US

Contacts

Phone	+1 256-229-6691
Fax	2562296866

Authorized person

Name	DR. DIANA MCCUTCHEON
Role	OWNER
Phone	2562296691

Taxonomy

Taxonomy Code	207Q00000X - Family Medicine Physician
License Number	00019246
State	AL
Is Primary	Yes

Other Provider Identifiers

Issuer	BLUE CROSS ID
Number	51521666
State	AL

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

LEXINGTON CLINIC PROFIT SHARING PLAN

2009

201054251

2010-07-14

LEXINGTON CLINIC

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2006-01-01
Business code	621111
Sponsor’s telephone number	2562296691
Plan sponsor’s address	11631 HIGHWAY 101, LEXINGTON, AL, 35648

Plan administrator’s name and address

Administrator’s EIN	201054251
Plan administrator’s name	LEXINGTON CLINIC
Plan administrator’s address	11631 HIGHWAY 101, LEXINGTON, AL, 35648
Administrator’s telephone number	2562296691

Signature of

Role	Plan administrator
Date	2010-07-14
Name of individual signing	DIANA MCCUTCHEON, MD

Role	Employer/plan sponsor
Date	2010-07-14
Name of individual signing	DIANA MCCUTCHEON, MD

Agent

Name	Role	Address
MCCUTCHEON, DIANA K	Agent	172 PUTMAN PARKWAYROGERSVILLE, AL 35652

Incorporator

Name	Role	Address
MCCUTCHEON, DIANA K	Incorporator	172 PUTMAN PARKWAYROGERSVILLE, AL 35652

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State