0001725402-18-000001.txt : 20180515 0001725402-18-000001.hdr.sgml : 20180515 20180515154353 ACCESSION NUMBER: 0001725402-18-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20180515 DATE AS OF CHANGE: 20180515 EFFECTIVENESS DATE: 20180515 FILER: COMPANY DATA: COMPANY CONFORMED NAME: Supira Medical, Inc. CENTRAL INDEX KEY: 0001725402 IRS NUMBER: 455466626 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-312450 FILM NUMBER: 18835994 BUSINESS ADDRESS: STREET 1: 590 DIVISION STREET CITY: CAMPBELL STATE: CA ZIP: 95008 BUSINESS PHONE: (510) 705-2569 MAIL ADDRESS: STREET 1: 590 DIVISION STREET CITY: CAMPBELL STATE: CA ZIP: 95008 D 1 primary_doc.xml X0708 D LIVE 0001725402 Supira Medical, Inc. 590 DIVISION STREET CAMPBELL CA CALIFORNIA 95008 (510) 705-2569 DELAWARE Lumenblation Medical, Inc. None Corporation true Jean Orth 590 Division Street Campbell CA CALIFORNIA 95008 Executive Officer Director Mariam Maghribi 590 Division Street Campbell CA CALIFORNIA 95008 Executive Officer Amr Salahieh 590 Division Street Campbell CA CALIFORNIA 95008 Director Casey Gordon 590 Division Street Campbell CA CALIFORNIA 95008 Director Other Decline to Disclose 06b false 2018-04-25 false true false 0 12884997 12884997 0 false 24 0 0 0 false Supira Medical, Inc. /s/ Jean Orth Jean Orth President and CEO 2018-05-15