| Entity Name: | VIVID DERMATOLOGY, LLC |
| Jurisdiction: | Connecticut |
| Legal type: | LLC |
| Citizenship: | Domestic |
| Status: | Active |
| Date Formed: | 15 May 2013 (Companies founded in May 2013) |
| Business ALEI: | 1107119 |
| Annual report due: | 31 Mar 2025 |
| NAICS code: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Business address: | 5 FOREST PARK DRIVE ROUTE 4, FARMINGTON, CT, 06032, United States |
| Mailing address: | FIVE FOREST PARK DRIVE ROUTE 4, FARMINGTON, CT, United States, 06032 |
| ZIP code: | 06032 (Companies in Hartford, 06032) |
| County: | Hartford |
| Place of Formation: | CONNECTICUT |
| E-Mail: | vivid.derm@comcast.net |
| Name | Role | Business address | Mailing address | Phone | Residence address | |
|---|---|---|---|---|---|---|
| DIANE HOSS | Agent | 5 FOREST PARK DRIVE ROUTE 4, FARMINGTON, CT, 06032, United States | 5 FOREST PARK DRIVE ROUTE 4, FARMINGTON, CT, 06032, United States | +1 860-212-4677 | vivid.derm@comcast.net | 22 MOUNTAIN LANE, FARMINGTON, CT, 06032, United States |
| Name | Role | Business address | Phone | Residence address | |
|---|---|---|---|---|---|
| DIANE HOSS | Officer | FIVE FOREST PARK DRIVE, ROUTE 4, FARMINGTON, CT, 06032, United States | +1 860-212-4677 | vivid.derm@comcast.net | 22 MOUNTAIN LANE, FARMINGTON, CT, 06032, United States |
| Credential | Credential type | Status | Status reason | Issue date | Effective date | Expiration date |
|---|---|---|---|---|---|---|
| CLAB.0000889 | Clinical Laboratory | ACTIVE | CURRENT | 2014-03-06 | 2024-04-01 | 2026-03-31 |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012163009 | 2024-01-31 | No data | Annual Report | Annual Report | No data |
| BF-0010818922 | 2023-01-13 | No data | Annual Report | Annual Report | No data |
| BF-0011301508 | 2023-01-13 | No data | Annual Report | Annual Report | No data |
| BF-0008480411 | 2023-01-13 | No data | Annual Report | Annual Report | 2020 |
| BF-0009875356 | 2023-01-13 | No data | Annual Report | Annual Report | No data |
| 0006498391 | 2019-03-27 | No data | Annual Report | Annual Report | 2019 |
| 0006393887 | 2019-02-20 | No data | Annual Report | Annual Report | 2018 |
| 0005856328 | 2017-06-05 | No data | Annual Report | Annual Report | 2017 |
| 0005571296 | 2016-05-21 | No data | Annual Report | Annual Report | 2015 |
| 0005571299 | 2016-05-21 | No data | Annual Report | Annual Report | 2016 |
Date of last update: 11 Nov 2024
Sources: Connecticut's Official State Website
