0001539252-12-000006.txt : 20120921 0001539252-12-000006.hdr.sgml : 20120921 20120921133025 ACCESSION NUMBER: 0001539252-12-000006 CONFORMED SUBMISSION TYPE: D/A PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: Rule 506 FILED AS OF DATE: 20120921 DATE AS OF CHANGE: 20120921 EFFECTIVENESS DATE: 20120921 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/A SEC ACT: 1933 Act SEC FILE NUMBER: 021-174213 FILM NUMBER: 121103785 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/A 1 primary_doc.xml X0706 D/A LIVE 0001539252 Provista Diagnostics Inc. 17301 N. Perimeter Dr., Suite 100 Scottsdale AZ ARIZONA 85255 (602) 952-3321 DELAWARE None None Corporation true 2012 David Reese 17301 N. Perimeter Dr., Suite 100 Scottsdale AZ ARIZONA 85255 Executive Officer Director President and Chief Executive Officer John Fermanis 17301 N. Perimeter Dr., Suite 100 Scottsdale AZ ARIZONA 85255 Executive Officer Chief Financial Officer Anne Busquet 17301 N. Perimeter Dr., Suite 100 Scottsdale AZ ARIZONA 85255 Director Jeffrey Gilman 17301 N. Perimeter Dr., Suite 100 Scottsdale AZ ARIZONA 85255 Director Robert Hariri 17301 N. Perimeter Dr., Suite 100 Scottsdale AZ ARIZONA 85255 Director Jack Levine 17301 N. Perimeter Dr., Suite 100 Scottsdale AZ ARIZONA 85255 Director John Macaskill 17301 N. Perimeter Dr., Suite 100 Scottsdale AZ ARIZONA 85255 Director John Zicarelli 17301 N. Perimeter Dr., Suite 100 Scottsdale AZ ARIZONA 85255 Director Biotechnology $1 - $1,000,000 06 true 0001539252-12-000005 2012-02-17 false true true true false 1652 7485891 7485891 0 false 32 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 2012-09-21