0001518913-16-000007.txt : 20161021 0001518913-16-000007.hdr.sgml : 20161021 20161021145408 ACCESSION NUMBER: 0001518913-16-000007 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20161021 DATE AS OF CHANGE: 20161021 EFFECTIVENESS DATE: 20161021 FILER: COMPANY DATA: COMPANY CONFORMED NAME: DermTech, Inc. CENTRAL INDEX KEY: 0001518913 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-273021 FILM NUMBER: 161946141 BUSINESS ADDRESS: STREET 1: 11099 N. TORREY PINES ROAD STREET 2: SUITE 100 CITY: LA JOLLA STATE: CA ZIP: 92037 BUSINESS PHONE: 858-450-4222 MAIL ADDRESS: STREET 1: 11099 N. TORREY PINES ROAD STREET 2: SUITE 100 CITY: LA JOLLA STATE: CA ZIP: 92037 FORMER COMPANY: FORMER CONFORMED NAME: DermTech International DATE OF NAME CHANGE: 20110425 D 1 primary_doc.xml X0707 D LIVE 0001518913 DermTech, Inc. 11099 N. TORREY PINES ROAD SUITE 100 LA JOLLA CA CALIFORNIA 92037 858-450-4222 DELAWARE DermTech International Corporation true John Dobak, M.D. c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Executive Officer Director Gary Jacobs c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Executive Officer Director Carl Peck, M.D. c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Director Gene Salkind, M.D. c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Director Steven Kemper c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Executive Officer Scott Pancoast c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Director Michael Willis c/o DermTech Inc. 11099 N. Torrey Pines Road, Suite 100 La Jolla CA CALIFORNIA 92037 Executive Officer Other Health Care Decline to Disclose 06b false 2016-10-07 false true true false 0 15512000 2066276 13445724 false 3 0 0 0 false DermTech, Inc. /s/ John Dobak John Dobak, M.D. President & CEO 2016-10-21