{"entity":{"id":13227678,"state":"FL","state_id":"K77706","entity_name":"CRESTVIEW MEDICAL CLINIC LABORATORY, INC.","entity_type":"DOMP","entity_type_normalized":"domestic_profit","status":"I","filing_date":"1989-03-29","filing_year":1989,"business_age_years":37,"principal_address1":"% JAMES L. CHASE","principal_address2":"101 EAST GOVERNMENT ST.","principal_city":"PENSACOLA","principal_state":"FL","principal_zip":"32501","principal_country":"","mail_address1":"% JAMES L. CHASE","mail_address2":"101 EAST GOVERNMENT ST.","mail_city":"PENSACOLA","mail_state":"FL","mail_zip":"32501","mail_country":"","location_name":null,"location_address1":null,"location_address2":null,"location_city":null,"location_state":null,"location_zip":null,"fei_ein":"592947432","jurisdiction":null,"county":null,"last_transaction_date":"12301991","report_year_1":"1991","report_date_1":"04121991","report_year_2":"1991","report_date_2":"04121991","report_year_3":"1990","report_date_3":"04251990","agent_name":"James L. Chase","agent_type":"C","agent_address":"101 EAST GOVERNMENT AVE.","agent_city":"PENSACOLA","agent_state":"FL","agent_zip":"32501","process_name":null,"process_address1":null,"process_address2":null,"process_city":null,"process_state":null,"process_zip":null,"source_file":"cordata6.txt","fetched_at":"2026-05-09 14:22:58","updated_at":"2026-05-09 14:22:58","last_accessed":null,"status_reason":null,"agent_name_raw":"CHASE, JAMES L."},"officers":[{"name":"David M. Campbell MD","first_name":"David","last_name":"Campbell","title":"Director","title_roles":["Director"],"title_code":"director","is_registered_agent":false,"address":"130 REDSTONE AVE.","city":"CRESTVIEW","state":"FL","zip":"","name_raw":"CAMPBELL, DAVID M.  M.D."},{"name":"Wayne E. Campbell MD","first_name":"Wayne","last_name":"Campbell","title":"Director","title_roles":["Director"],"title_code":"director","is_registered_agent":false,"address":"130 REDSTONE AVE.","city":"CRESTVIEW","state":"FL","zip":"","name_raw":"CAMPBELL, WAYNE E.  M.D."},{"name":"John T. Johnson","first_name":"John","last_name":"Johnson","title":"Director","title_roles":["Director"],"title_code":"director","is_registered_agent":false,"address":"130 REDSTONE AVE.","city":"CRESTVIEW","state":"FL","zip":"","name_raw":"JOHNSON, JOHN T."},{"name":"Gary W., M.T. Pangle","first_name":"Gary","last_name":"Pangle","title":"Vice President","title_roles":["Vice President"],"title_code":"vp","is_registered_agent":false,"address":"130 REDSTONE AVENUE","city":"CRESTVIEW","state":"FL","zip":"","name_raw":"PANGLE, GARY W., M.T."},{"name":"Rick E., R.T. Smith","first_name":"Rick","last_name":"Smith","title":"President","title_roles":["President"],"title_code":"president","is_registered_agent":false,"address":"130 REDSTONE AVENUE","city":"CRESTVIEW","state":"FL","zip":"","name_raw":"SMITH, RICK E., R.T."},{"name":"R. Lee Thigpen MD","first_name":"R.","last_name":"Thigpen","title":"Director","title_roles":["Director"],"title_code":"director","is_registered_agent":false,"address":"130 REDSTONE AVE.","city":"CRESTVIEW","state":"FL","zip":"","name_raw":"THIGPEN, R. LEE     M.D."}],"filing_history":[],"status_history":[],"unknown":["status_history: we do not collect status-change histories from the source feeds, so this empty list means we hold none — NOT that this company's status has never changed. Observed changes we DID see are under `history`."],"verified_domains":[],"history":null,"web_contact":null,"provenance_url":"https://private.rootz.global/api/provenance/FL/K77706"}