0001679969-16-000001.txt : 20160720 0001679969-16-000001.hdr.sgml : 20160720 20160720124259 ACCESSION NUMBER: 0001679969-16-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20160720 DATE AS OF CHANGE: 20160720 EFFECTIVENESS DATE: 20160720 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Indiana Clinical Laboratories LLC CENTRAL INDEX KEY: 0001679969 IRS NUMBER: 473109996 STATE OF INCORPORATION: IN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-267372 FILM NUMBER: 161774952 BUSINESS ADDRESS: STREET 1: 5635 W. 96TH STREET STREET 2: SUITE 300 CITY: INDIANAPOLIS STATE: IN ZIP: 46278 BUSINESS PHONE: 317-385-2082 MAIL ADDRESS: STREET 1: 5635 W. 96TH STREET STREET 2: SUITE 300 CITY: INDIANAPOLIS STATE: IN ZIP: 46278 D 1 primary_doc.xml X0707 D LIVE 0001679969 Indiana Clinical Laboratories LLC 5635 W. 96TH STREET SUITE 300 INDIANAPOLIS IN INDIANA 46278 317-385-2082 INDIANA None None Limited Liability Company true 2015 Brad Van Pelt 5635 W. 96th Street Suite 300 Indianapolis IN INDIANA 46278 Executive Officer Promoter Vipin Adhlakha 5635 W. 96th Street Suite 300 Indianapolis IN INDIANA 46278 Executive Officer Promoter Other Health Care Decline to Disclose 06b false 2015-08-03 false true false 8000 600000 232000 368000 false 5 0 0 0 true No specific allocation of payment to executive officers, directors, or promoters; however, offering proceeds may be used, in part, for working capital including fees and salary for executive officers, directors or promoters false Indiana Clinical Laboratories LLC /s/ Brad Van Pelt Brad Van Pelt CEO and Manager 2016-07-20