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Madison Core Laboratories, LLC

Details

Name: Madison Core Laboratories, LLC
Jurisdiction: Alabama
Legal type: Foreign Limited Liability Company
Status: Exists
Date of registration: 20 Jan 2015 (10 years ago)
Entity Number: 000-326-752
Register Number: 000326752
County: Madison
Place of Formation: Delaware
Principal Address: 2705 ARTIE ST SW STE 30HUNTSVILLE, AL 35805
Principal Address ZIP Code: 35805
Principal Mailing Address: PO BOX 1505HUNTSVILLE, AL 35807
Principal Mailing Address ZIP Code: 35807

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1174912695 2015-01-21 2022-11-01 PO BOX 1565, HUNTSVILLE, AL, 358070565, US 2705 ARTIE ST SW, BLDG 400 SUITE 25, HUNTSVILLE, AL, 35805, US

Contacts
Phone +1 256-850-0075
Fax 2568503186

Authorized person
Name GUY E JONES
Role CREDENTIALING
Phone 2568500075

Taxonomy
Taxonomy Code 291U00000X - Clinical Medical Laboratory
Is Primary Yes

Other Provider Identifiers
Issuer CLIA
Number 01D2116823
State AL
Issuer NPI
Number 1174912695
Issuer DEPT. OF PUBLIC HEALTH
Number L4593
State AL
Issuer CLIA
Number 01D2097667
State AL
Issuer DEPT. OF PUBLIC HEALTH
Number L45100
State AL

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
7CAM9 Active Non-Manufacturer 2015-03-30 2024-01-16 2029-01-16 2025-01-11

Contact Information
POC CARLO A. CRESPO
Phone +1 256-850-0075
Fax +1 256-850-3186
Address 2705 ARTIE ST SW STE 30, HUNTSVILLE, AL, 35805 4732, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MADISON CORE LABORATORIES, LLC 401(K) PLAN 2023 472859989 2024-07-10 MADISON CORE LABORATORIES, LLC 77
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-03-11
Business code 541380
Sponsor’s telephone number 2568500075
Plan sponsor’s address 2705 ARTIE ST SW STE 30, HUNTSVILLE, AL, 35805

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2024-07-09
Name of individual signing QIAN LIU
MADISON CORE LABORATORIES, LLC 401(K) PLAN 2022 472859989 2023-06-16 MADISON CORE LABORATORIES, LLC 61
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-03-11
Business code 541380
Sponsor’s telephone number 2568500075
Plan sponsor’s address 2705 ARTIE ST SW STE 30, HUNTSVILLE, AL, 35805

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2023-06-16
Name of individual signing CHRISTINE RIMER
MADISON CORE LABORATORIES, LLC 401(K) PLAN 2021 472859989 2022-07-16 MADISON CORE LABORATORIES, LLC 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-03-11
Business code 541380
Sponsor’s telephone number 2568500075
Plan sponsor’s address 2705 ARTIE ST SW STE 30, HUNTSVILLE, AL, 35805

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-07-15
Name of individual signing CHRISTINE RIMER
MADISON CORE LABORATORIES, LLC 401(K) PLAN 2020 472859989 2021-07-16 MADISON CORE LABORATORIES, LLC 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-03-11
Business code 541380
Sponsor’s telephone number 2568500075
Plan sponsor’s address 120 WEST DUBLIN DR. - STE. 105, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-07-15
Name of individual signing CAROL HO
MADISON CORE LABORATORIES, LLC 401(K) PLAN 2019 472859989 2020-07-03 MADISON CORE LABORATORIES, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-03-11
Business code 541380
Sponsor’s telephone number 2568500075
Plan sponsor’s address 120 WEST DUBLIN DR. - STE. 105, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2020-07-02
Name of individual signing CAROL HO
MADISON CORE LABORATORIES, LLC 401(K) PLAN 2018 472859989 2019-07-24 MADISON CORE LABORATORIES, LLC 3
Three-digit plan number (PN) 001
Effective date of plan 2018-03-11
Business code 541380
Sponsor’s telephone number 2568500075
Plan sponsor’s address 120 WEST DUBLIN DR. - STE. 105, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2019-07-24
Name of individual signing CAROL HO
MADISON CORE LABORATORIES, LLC 401(K) PLAN 2018 472859989 2020-05-18 MADISON CORE LABORATORIES, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-03-11
Business code 541380
Sponsor’s telephone number 2568500075
Plan sponsor’s address 120 WEST DUBLIN DR. - STE. 105, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2020-05-18
Name of individual signing CAROL HO

Agent

Name Role
CAPITOL CORPORATE SERVICES INC Agent

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Related by address

No related companies by address

Date of last update: 03 Aug 2024

Sources: Alabama Secretary of State

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