| Name: | EAST SIDE CLINICAL LABORATORY, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 28 Jun 1979 (46 years ago) |
| Identification Number: | 000011261 |
| ZIP code: | 02914 |
| County: | Providence County |
| Principal Address: | 10 RISHO AVENUE, EAST PROVIDENCE, RI, 02914, USA |
| Purpose: | MEDICAL LABORATORY |
| NAICS: | 621511 - Medical Laboratories |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | EAST SIDE CLINICAL LABORATORY, INC., CONNECTICUT | 1250942 | CONNECTICUT |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861404121 | 2006-08-13 | 2024-09-30 | 10 RISHO AVE, EAST PROVIDENCE, RI, 029141227, US | 10 RISHO AVE, EAST PROVIDENCE, RI, 029141227, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 401-455-8400 |
| Fax | 4014558444 |
Authorized person
| Name | ALAN M. GREENBERG |
| Role | PRESIDENT |
| Phone | 5163965800 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| License Number | LCI00449 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 9418005 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| DR. COLIN S. GOLDSCHMIDT | DIRECTOR | LEVEL 22, GROSVENOR PLACE, 225 GEORGE ST SYDNEY NSW, 2000 AU |
| CHRISTOPHER D WILKS | DIRECTOR | LEVEL 22, GROSVENOR PLACE, 225 GEORGE ST SYDNEY NSW, 2000 AU |
| JERRY W HUSSONG MBA MD | DIRECTOR | 12357-A RIATA TRACE PARKWAY, SUITED 210 AUSTIN, TX 78727 USA |
| Name | Role | Address |
|---|---|---|
| ALAN M. GREENBERG | PRESIDENT | 250 MILLER PLACE HICKSVILLE, NY 11801 USA |
| Name | Role | Address |
|---|---|---|
| JAMES K. WEST | TREASURER | 12357-A RIATA TRACE PARKWAY, SUITE 210 AUSTIN, TX 78727 USA |
| Number | Name | File Date |
|---|---|---|
| 202457962760 | Annual Report | 2024-07-16 |
| 202457105130 | Revocation Notice For Failure to File An Annual Report | 2024-06-25 |
| 202335027800 | Annual Report | 2023-05-01 |
| 202216394250 | Annual Report | 2022-04-29 |
| 202193391970 | Annual Report | 2021-03-01 |
| 202035537780 | Annual Report | 2020-02-28 |
| 201926450300 | Annual Report | 2019-10-31 |
| 201926400440 | Annual Report - Amended | 2019-10-31 |
| 201987543670 | Annual Report | 2019-02-26 |
| 201858198950 | Annual Report | 2018-02-13 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BPA CALL | AWARD | 36C24125N0020 | 2024-10-01 | 2025-09-30 | 2025-09-30 | |||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||
| Obligated Amount | 30000.00 |
| Current Award Amount | 30000.00 |
| Potential Award Amount | 30000.00 |
Description
| Title | PHLEBOTOMY AND URINE COLLECTION SERVICES |
| NAICS Code | 621511: MEDICAL LABORATORIES |
| Product and Service Codes | Q301: REFERENCE LABORATORY TESTING |
Recipient Details
| Recipient | EAST SIDE CLINICAL LABORATORY, INC. |
| UEI | C7GTDCMRWVN5 |
| Recipient Address | UNITED STATES, 10 RISHO AVE STE C, EAST PROVIDENCE, PROVIDENCE, RHODE ISLAND, 029141227 |
| Unique Award Key | CONT_AWD_36C24124N0010_3600_36C24120A0085_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 54000.00 |
| Current Award Amount | 54000.00 |
| Potential Award Amount | 54000.00 |
Description
| Title | PHLEBOTOMY AND URINE COLLECTION SERVICES |
| NAICS Code | 621511: MEDICAL LABORATORIES |
| Product and Service Codes | Q301: REFERENCE LABORATORY TESTING |
Recipient Details
| Recipient | EAST SIDE CLINICAL LABORATORY, INC. |
| UEI | C7GTDCMRWVN5 |
| Recipient Address | UNITED STATES, 10 RISHO AVE STE C, EAST PROVIDENCE, PROVIDENCE, RHODE ISLAND, 029141227 |
| Unique Award Key | CONT_AWD_36C24123N0016_3600_36C24120A0085_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 33252.50 |
| Current Award Amount | 33252.50 |
| Potential Award Amount | 33252.50 |
Description
| Title | PHLEBOTOMY AND URINE COLLECTION SERVICES |
| NAICS Code | 621511: MEDICAL LABORATORIES |
| Product and Service Codes | Q301: REFERENCE LABORATORY TESTING |
Recipient Details
| Recipient | EAST SIDE CLINICAL LABORATORY, INC. |
| UEI | C7GTDCMRWVN5 |
| Recipient Address | UNITED STATES, 10 RISHO AVE STE C, EAST PROVIDENCE, PROVIDENCE, RHODE ISLAND, 029141227 |
| Unique Award Key | CONT_IDV_36C24120A0085_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 0.00 |
| Potential Award Amount | 280000.00 |
Description
| Title | PHLEBOTOMY AND URINE COLLECTION SERVICES |
| NAICS Code | 621511: MEDICAL LABORATORIES |
| Product and Service Codes | Q301: REFERENCE LABORATORY TESTING |
Recipient Details
| Recipient | EAST SIDE CLINICAL LABORATORY, INC. |
| UEI | C7GTDCMRWVN5 |
| Recipient Address | UNITED STATES, 10 RISHO AVE STE C, EAST PROVIDENCE, PROVIDENCE, RHODE ISLAND, 029141227 |
Date of last update: 05 Oct 2024
Sources: Rhode Island Department of State
