0001815087-21-000001.txt : 20210823 0001815087-21-000001.hdr.sgml : 20210823 20210823123530 ACCESSION NUMBER: 0001815087-21-000001 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20210823 DATE AS OF CHANGE: 20210823 EFFECTIVENESS DATE: 20210823 FILER: COMPANY DATA: COMPANY CONFORMED NAME: MicrobiomX, Inc. CENTRAL INDEX KEY: 0001815087 IRS NUMBER: 845037626 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-410903 FILM NUMBER: 211196074 BUSINESS ADDRESS: STREET 1: 2826 11TH AVE. E. CITY: SEATTLE STATE: WA ZIP: 98102 BUSINESS PHONE: 206-351-2662 MAIL ADDRESS: STREET 1: 2826 11TH AVE. E. CITY: SEATTLE STATE: WA ZIP: 98102 D 1 primary_doc.xml X0708 D LIVE 0001815087 MicrobiomX, Inc. 2826 11TH AVE. E. SEATTLE WA WASHINGTON 98102 206-351-2662 DELAWARE None None Corporation true 2020 Roslyn Hendriks 3716 Leeward Lane Anacortes WA WASHINGTON 98221 Executive Officer Director Kathleen Lendvay 2826 11th Ave. East Seattle WA WASHINGTON 98102 Executive Officer Director Thomas Lendvay 2826 11th Ave. East Seattle WA WASHINGTON 98102 Executive Officer Director Other Technology Decline to Disclose 06b false 2021-08-13 false true false 0 2000000 1337500 662500 false 40 0 0 0 false MicrobiomX, Inc. /s/ Roslyn Hendriks Roslyn Ann Hendriks Chair & CEO 2021-08-20