0001539252-12-000005.txt : 20120301 0001539252-12-000005.hdr.sgml : 20120301 20120301163520 ACCESSION NUMBER: 0001539252-12-000005 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20120301 DATE AS OF CHANGE: 20120301 EFFECTIVENESS DATE: 20120301 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Provista Diagnostics Inc. CENTRAL INDEX KEY: 0001539252 IRS NUMBER: 274282214 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-174213 FILM NUMBER: 12658218 BUSINESS ADDRESS: STREET 1: 6225 NORTH 24TH STREET, SUITE 150 CITY: PHOENIX STATE: AZ ZIP: 85016 BUSINESS PHONE: (602) 952-3321 MAIL ADDRESS: STREET 1: 6225 NORTH 24TH STREET, SUITE 150 CITY: PHOENIX STATE: AZ ZIP: 85016 D 1 primary_doc.xml X0704 D LIVE 0001539252 Provista Diagnostics Inc. 6225 NORTH 24TH STREET, SUITE 150 PHOENIX AZ ARIZONA 85016 (602) 254-5500 DELAWARE None None Corporation true 2009 David Reese 6225 NORTH 24TH STREET, SUITE 150 PHOENIX AZ ARIZONA 85016 Executive Officer Director President and Chief Executive Officer John Fermanis 6225 NORTH 24TH STREET, SUITE 150 PHOENIX AZ ARIZONA 85016 Executive Officer Chief Financial Officer William Gartner 6225 NORTH 24TH STREET, SUITE 150 PHOENIX AZ ARIZONA 85016 Executive Officer Executive Vice President Anne Busquet 6225 NORTH 24TH STREET, SUITE 150 PHOENIX AZ ARIZONA 85016 Director Jeffrey Gilman 6225 NORTH 24TH STREET, SUITE 150 PHOENIX AZ ARIZONA 85016 Director Robert Hariri 6225 NORTH 24TH STREET, SUITE 150 PHOENIX AZ ARIZONA 85016 Director Jack Levine 6225 NORTH 24TH STREET, SUITE 150 PHOENIX AZ ARIZONA 85016 Director John Macaskill 6225 NORTH 24TH STREET, SUITE 150 PHOENIX AZ ARIZONA 85016 Director John Zicarelli 6225 NORTH 24TH STREET, SUITE 150 PHOENIX AZ ARIZONA 85016 Director Biotechnology $1 - $1,000,000 06 false 2012-02-17 false true true true false 25000 4950000 4510000 440000 false 18 0 0 52000 true Note repayment to an entity controlled by a director. false Provista Diagnostics Inc. John N. Fermanis John N. Fermanis Chief Financial Officer 2012-03-01