| Entity Name: | OMAR A. IBRAHIMI, MD, PHD, LLC |
| Jurisdiction: | Connecticut |
| Legal type: | LLC |
| Citizenship: | Domestic |
| Status: | Active |
| Sub status: | Annual report due |
| Date Formed: | 23 Apr 2012 |
| Business ALEI: | 1069115 |
| Annual report due: | 31 Mar 2025 |
| NAICS code: | 541990 - All Other Professional, Scientific, and Technical Services |
| Business address: | 2777 SUMMER STREETSUITE 600, STAMFORD, CT, 06905, United States |
| Mailing address: | 2777 SUMMER STREETSUITE 600, STAMFORD, CT, United States, 06905 |
| ZIP code: | 06905 |
| County: | Fairfield |
| Place of Formation: | CONNECTICUT |
| E-Mail: | manager@ctskindoc.com |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7AXU2 | Active | Non-Manufacturer | 2015-01-27 | 2024-03-08 | No data | No data | |||||||||||||
|
|||||||||||||||||||
| POC | SADIA IBRAHIMI |
| Phone | +1 203-428-4440 |
| Address | 999 SUMMER ST STE 205, STAMFORD, FAIRFIELD, CT, 06905 5513, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | Information not Available |
|---|
| List of Offerors (0) | Information not Available |
|---|
| Name | Role | Business address | Mailing address | Phone | Residence address | |
|---|---|---|---|---|---|---|
| OMAR A. IBRAHIMI | Agent | 2777 SUMMER STREET, SUITE 600, STAMFORD, CT, 06905, United States | 2777 SUMMER STREET, SUITE 600, STAMFORD, CT, 06905, United States | +1 203-241-1627 | manager@ctskindoc.com | 2 HAMPTON RD, DARIEN, CT, 06820, United States |
| Name | Role | Business address | Phone | Residence address | |
|---|---|---|---|---|---|
| OMAR A. IBRAHIMI | Officer | 2777 SUMMER ST SUITE 600, STAMFORD, CT, 06905, United States | +1 203-241-1627 | manager@ctskindoc.com | 2 HAMPTON RD, DARIEN, CT, 06820, United States |
| Credential | Credential type | Status | Status reason | Issue date | Effective date | Expiration date |
|---|---|---|---|---|---|---|
| CLAB.0001078 | Clinical Laboratory | ACTIVE | CURRENT | 2022-08-24 | 2024-10-01 | 2026-09-30 |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012198351 | 2024-03-13 | No data | Annual Report | Annual Report | No data |
| BF-0011433359 | 2023-01-25 | No data | Annual Report | Annual Report | No data |
| BF-0010359264 | 2022-03-31 | No data | Annual Report | Annual Report | 2022 |
| 0007127743 | 2021-02-05 | No data | Annual Report | Annual Report | 2021 |
| 0006780214 | 2020-02-25 | No data | Annual Report | Annual Report | 2020 |
| 0006305070 | 2019-01-03 | No data | Annual Report | Annual Report | 2019 |
| 0006150681 | 2018-04-03 | No data | Annual Report | Annual Report | 2018 |
| 0006150678 | 2018-04-03 | No data | Annual Report | Annual Report | 2017 |
| 0005532922 | 2016-04-11 | No data | Annual Report | Annual Report | 2016 |
| 0005324879 | 2015-04-30 | No data | Annual Report | Annual Report | 2015 |
Date of last update: 06 Jan 2025
Sources: Connecticut's Official State Website
