0001493152-24-024828.txt : 20240621
0001493152-24-024828.hdr.sgml : 20240621
20240621174513
ACCESSION NUMBER: 0001493152-24-024828
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240611
FILED AS OF DATE: 20240621
DATE AS OF CHANGE: 20240621
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Rachman Ilya M
CENTRAL INDEX KEY: 0001889334
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41159
FILM NUMBER: 241061535
MAIL ADDRESS:
STREET 1: 11400 WEST OLYMPIC BLVD.,
STREET 2: SUITE 200
CITY: LOS ANGELES
STATE: CA
ZIP: 90064
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Immix Biopharma, Inc.
CENTRAL INDEX KEY: 0001873835
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
ORGANIZATION NAME: 03 Life Sciences
IRS NUMBER: 454869378
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 11400 WEST OLYMPIC BLVD.
STREET 2: SUITE 200
CITY: LOS ANGELES
STATE: CA
ZIP: 90064
BUSINESS PHONE: (888) 958-1084
MAIL ADDRESS:
STREET 1: 10573 W. PICO BLVD.
STREET 2: #58
CITY: LOS ANGELES
STATE: CA
ZIP: 90064
4
1
ownership.xml
X0508
4
2024-06-11
0
0001873835
Immix Biopharma, Inc.
IMMX
0001889334
Rachman Ilya M
C/O IMMIX BIOPHARMA, INC.
11400 WEST OLYMPIC BLVD., SUITE 200
LOS ANGELES
CA
90064
1
1
0
0
CEO and Chairman
0
Common Stock
1136259
D
Stock Option (Right to Buy)
2.04
2024-06-11
4
A
0
340000
0.00
A
2034-06-11
Common Stock
340000
340000
D
The Stock Option will vest in 48 equal monthly installments following the date of grant, subject to the Reporting Person's continued service with the Issuer.
/s/ Ilya Rachman
2024-06-21