| Entity Name: | WALLINGFORD ENDOSCOPY CENTER, LLC |
| Jurisdiction: | Connecticut |
| Legal type: | LLC |
| Citizenship: | Domestic |
| Status: | Active |
| Sub status: | Annual report due |
| Date Formed: | 22 Aug 2016 |
| Business ALEI: | 1214937 |
| Annual report due: | 31 Mar 2025 |
| NAICS code: | 621493 - Freestanding Ambulatory Surgical and Emergency Centers |
| Business address: | 863 NORTH MAIN STREET EXTENSION SUITE 300, WALLINGFORD, CT, 06492, United States |
| Mailing address: | 863 NORTH MAIN STREET EXTENSION SUITE 300, WALLINGFORD, CT, United States, 06492 |
| ZIP code: | 06492 |
| County: | New Haven |
| Place of Formation: | CONNECTICUT |
| E-Mail: | scordone@connecticutgi.org |
| Name | Role | Business address | Mailing address | Phone | Residence address | |
|---|---|---|---|---|---|---|
| SAM SHEIKER | Agent | 863 N MAIN STREET EXT STE 300, WALLINGFORD, CT, 06492, United States | 863 N MAIN STREET EXT SUITE 300, WALLINGFORD, CT, 06492, United States | +1 774-991-2228 | scordone@connecticutgi.org | CONNECTICUT, 15 HADLEY DRIVE, AVON, CT, 06001, United States |
| Name | Role | Business address | Phone | Residence address | |
|---|---|---|---|---|---|
| MIDSTATE MEDICAL CENTER | Officer | 435 LEWIS AVENUE, MERIDEN, CT, 06451, United States | No data | No data | 435 LEWIS AVE., MERIDEN, CT, 06451, United States |
| SAM SHEIKER | Officer | 863 N MAIN STREET EXT STE 300, WALLINGFORD, CT, 06492, United States | +1 774-991-2228 | scordone@connecticutgi.org | CONNECTICUT, 15 HADLEY DRIVE, AVON, CT, 06001, United States |
| Credential | Credential type | Status | Status reason | Issue date | Effective date | Expiration date |
|---|---|---|---|---|---|---|
| ASC.0000359 | Out-Patient Surgical Facility | CLOSED | CLOSED | No data | No data | No data |
| ASC.0000360 | Out-Patient Surgical Facility | ACTIVE | CURRENT | 2018-10-12 | 2024-10-01 | 2026-09-30 |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012252550 | 2024-01-18 | No data | Annual Report | Annual Report | No data |
| BF-0011463360 | 2023-02-01 | No data | Annual Report | Annual Report | No data |
| BF-0010231478 | 2022-02-07 | No data | Annual Report | Annual Report | 2022 |
| 0007170921 | 2021-02-12 | No data | Annual Report | Annual Report | 2021 |
| 0006950703 | 2020-07-06 | 2020-07-06 | Change of Agent Address | Agent Address Change | No data |
| 0006943532 | 2020-07-06 | 2020-07-06 | Change of Agent Address | Agent Address Change | No data |
| 0006854531 | 2020-03-30 | 2020-03-30 | Change of Agent | Agent Change | No data |
| 0006828132 | 2020-03-12 | No data | Annual Report | Annual Report | 2020 |
| 0006383367 | 2019-02-14 | No data | Annual Report | Annual Report | 2019 |
| 0006108805 | 2018-03-06 | No data | Annual Report | Annual Report | 2018 |
Date of last update: 25 Nov 2024
Sources: Connecticut's Official State Website
