URINE - STRIP AND SEDIMENTATION First registration: Registred client: Participant ID1 Laboratory name: Address: City: State: Country: Telephone number: Fax number: Mailing address2: City: County: Contact person: Primary e-mail address: Alternative e-mail address: Period of contract: Samples/assay: 1 sample 2 sample Number of instruments tested: I hereby confirm that all the submited datas are correct. Signature 1 2 Date: In case of new registration the Participant Idea will be completed by the organizers. Complete mailing address only if differes from the main address Participant: Fill up the questionnaire with data regarding the instrument used for the determination of the parameters. If you would like multi-instrument evaluation please fill up a questionnaire for each of the instruments. Instrucţiuni: Instrument: Write the name of the instrument you use for the analysis Reagent producer: Write the name of of the reagent producer Instrument: Producător reactivi: For further information please contact Nobis Labordiagnostica: Tel: +40-264-403.516, +40-726-155270 Fax:+40-264-449.711 E-mail: [email protected] Contact person: Peter Stelescu – Product Manager QS Nobis Labordiagnostica S.R.L 18 Fântânele street, Cluj-Napoca, Cluj County, Romania
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