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Lee Pathology Laboratory, LLP

Details

Name: Lee Pathology Laboratory, LLP
Jurisdiction: Alabama
Legal type: Domestic Registered Limited Liability Partnership
Status: Dissolved
Date of registration: 31 Mar 2005 (20 years ago)
Date of dissolution: 05 Aug 2015
Entity Number: 000-401-270
Register Number: 000401270
County: Lee
Place of Formation: Lee County
Principal Address: 503 E THOMASON CIRCLEOPELIKA, AL 36801
Principal Address ZIP Code: 36801

Activities PROVIDING LABORATORY SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1154353639 2006-07-07 2007-07-26 503 E THOMASON CIR, OPELIKA, AL, 368015431, US 503 E THOMASON CIR, OPELIKA, AL, 368015431, US

Contacts
Phone +1 334-749-8234
Fax 3347499353

Authorized person
Name DR. MICHAEL P JOHNSON
Role PATHOLOGIST/OWNER
Phone 3347498234

Taxonomy
Taxonomy Code 291U00000X - Clinical Medical Laboratory
License Number 12339
State AL
Is Primary Yes

Other Provider Identifiers
Issuer GROUP
Number 000053518
State AL
Issuer MEDICAID
Number 000053518
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LEE PATHOLOGY LABORATORY PROFIT SHARING PLAN 2013 630858967 2014-11-07 LEE PATHOLOGY LABORATORY 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-01-01
Business code 621510
Sponsor’s telephone number 3347498234
Plan sponsor’s address 503 EAST THOMPSON CIR, OPELIKA, AL, 36801

Signature of
Role Plan administrator
Date 2014-11-07
Name of individual signing DR. MICHAEL P JOHNSON
LEE PATHOLOGY LABORATORY PROFIT SHARING PLAN 2013 630858967 2014-07-28 LEE PATHOLOGY LABORATORY 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-01-01
Business code 621510
Sponsor’s telephone number 3347498234
Plan sponsor’s address 503 EAST THOMPSON CIR, OPELIKA, AL, 36801

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing FRANK HARRISON
LEE PATHOLOGY LABORATORY PROFIT SHARING PLAN 2013 630858967 2014-05-01 LEE PATHOLOGY LABORATORY 13
Three-digit plan number (PN) 001
Effective date of plan 1986-01-01
Business code 621510
Sponsor’s telephone number 3347498234
Plan sponsor’s address 503 EAST THOMPSON CIR, OPELIKA, AL, 36801

Signature of
Role Plan administrator
Date 2014-05-01
Name of individual signing DR. MICHAEL P JOHNSON
LEE PATHOLOGY LABORATORY PROFIT SHARING PLAN 2012 630858967 2013-03-26 LEE PATHOLOGY LABORATORY 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-01-01
Business code 621510
Sponsor’s telephone number 3347498234
Plan sponsor’s address 503 EAST THOMPSON CIR, OPELIKA, AL, 36801

Signature of
Role Plan administrator
Date 2013-03-26
Name of individual signing DR. MICHAEL P JOHNSON
LEE PATHOLOGY LABORATORY PROFIT SHARING PLAN 2011 630858967 2012-04-26 LEE PATHOLOGY LABORATORY 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-01-01
Business code 621510
Sponsor’s telephone number 3347498234
Plan sponsor’s address 503 EAST THOMPSON CIR, OPELIKA, AL, 36801

Plan administrator’s name and address
Administrator’s EIN 630858967
Plan administrator’s name LEE PATHOLOGY LABORATORY
Plan administrator’s address 503 EAST THOMPSON CIR, OPELIKA, AL, 36801
Administrator’s telephone number 3347498234

Signature of
Role Plan administrator
Date 2012-04-26
Name of individual signing DR. MICHAEL P JOHNSON
LEE PATHOLOGY LABORATORY PROFIT SHARING PLAN 2010 630858967 2011-08-17 LEE PATHOLOGY LABORATORY 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-01-01
Business code 621510
Sponsor’s telephone number 3347498234
Plan sponsor’s address 503 EAST THOMPSON CIR, OPELIKA, AL, 36801

Plan administrator’s name and address
Administrator’s EIN 630858967
Plan administrator’s name LEE PATHOLOGY LABORATORY
Plan administrator’s address 503 EAST THOMPSON CIR, OPELIKA, AL, 36801
Administrator’s telephone number 3347498234

Signature of
Role Plan administrator
Date 2011-08-17
Name of individual signing DR. MICHAEL P JOHNSON
LEE PATHOLOGY LAB PSP 2009 630858967 2010-06-03 LEE PATHOLOGY LABORATORY 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-01-01
Business code 621510
Sponsor’s telephone number 3347498234
Plan sponsor’s address 503 E THOMASON CIR, OPELIKA, AL, 368015431

Plan administrator’s name and address
Administrator’s EIN 630858967
Plan administrator’s name LEE PATHOLOGY LABORATORY
Plan administrator’s address 503 E THOMASON CIR, OPELIKA, AL, 368015431
Administrator’s telephone number 3347498234

Signature of
Role Plan administrator
Date 2010-06-03
Name of individual signing AUTHORIZED SIGNER

Agent

Name Role Address
JOHNSON, MICHAEL P Agent 655 GALLATIN STREET SWHUNTSVILLE, AL 35801

Related by officers

JOHNSON, MICHAEL P

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Related by address

503 E THOMASON CIRCLEOPELIKA, AL 36801

Pathology Laboratory, P.A.

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State

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