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FDA Medical Device Registration Form

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Establishment Details

Establishment Name

Street Address

City

State

Post Code

FDA Registration Number

DUNS Number

I hereby authorize Cosmereg LLC to obtain duns number on our behalf for an additional fess of 100 USD

Establishment Contact

Name of Contact Person

Job Title

Mailing Address

City

State

Postal Code

Tel Number

E-mail

Other Business Names

Type of Operation

Manufacturer

Contract Manufacturer

Contract Sterilizer

Specification Developer

Initial Importer

Foreign Exporter

Relabeler

Other

Other (Explain)

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US Importer / Distributor

US Importer Name

FDA Registration Number

DUNS Number

Address

E-mail

Tel Number

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Device Listing Information

Device Listing Information - 1

Proprietary Name

Common Name

Device Class

Device Code

510 (K) Number

Device Listing Information - 2

Proprietary Name

Common Name

Device Class

Device Code

510 (K) Number

Device Listing Information - 3

Proprietary Name

Common Name

Device Class

Device Code

510 (K) Number

Device Listing Information - 4

Proprietary Name

Common Name

Device Class

Device Code

510 (K) Number

Device Listing Information - 5

Proprietary Name

Common Name

Device Class

Device Code

510 (K) Number

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US FDA Medical Device Registration Form Submitter Information

Submitter Name

Job Title

Submitter E-mail

Next Previous

Review

U.S Agent Terms and Condition

I Agree terms and conditions mentioned above. *

Submit Previous

Thank you for submission

We will contact you soon.

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Tampa/St.Petersburg, USA +17273509380

Cosmereg LLC
7901 4th St. N STE 4016
Tampa/St. Petersburg,
FL 33702, USA

London, UK +442033182439

Cosmereg LTD
22 Eastcheap street
EC3M 1EU, London,UK

Seoul, South Korea 00308 491 0226 Kakaotalk ID: Cosmereg

Qui sommes-nous?
Nos services
FDA Registration
- FDA Medical Device Registartion
- Drug Establishment Registartion
Blog
Contactez nous

Establishment Details

Establishment Contact

US Importer / Distributor

Device Listing Information

US FDA Medical Device Registration Form Submitter Information

Review

Thank you for submission

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Contacts