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LONGEVITY LABORATORY, LLC

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Company Details

Legal Name: LONGEVITY LABORATORY, LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: March 13th 2007
Date of Dissolution: February 9th 2023
Expiration date: 31 Mar 2022
UBI Number: 602 705 650
ZIP code: 98034
City: Kirkland
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 11335 NE 122ND WAY STE 140, KIRKLAND, WA, 98034-6919, UNITED STATES

Contact Details

E-Mail: RA_WAGNER@COMCAST.NET
Phone Number: +1 206-786-2902

Nature of Business

Other Services, Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
ROBERT WAGNER Registered Agent 11335 NE 122ND WAY STE 140, KIRKLAND, WA, 98034-6919, UNITED STATES

Key Officers & Management

Name Role Address
SETH TALBOTT Governing Person 11410 NE 122ND WAY, ST 102, KIRKLAND, WA, 98034, UNITED STATES
JERRY MIYON Governing Person 11410 NE 122ND WAY, ST 102, KIRKLAND, WA, 98034, UNITED STATES
PETE TALBOTT Governing Person 11410 NE 122ND WAY, ST 102, KIRKLAND, WA, 98034, UNITED STATES
LLC LONGEVITY DEVELOPMENT EXECUTOR 9757 NE JUANITA DR #200, KIRKLAND, WA, 98034, UNITED STATES

National Provider Identifier

NPI Number:
1609123330

Authorized Person:

Name:
DR. JERRY NELSON MIXON
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
291U00000X - Clinical Medical Laboratory
Is Primary:
Yes

Contacts:

Fax:
4256540211
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