Plant Location / Paint Branch Parkway College / FACILITY CONTACT PERSON Name / /
IndustryTerm
search existing data sources / /
Organization
U.S. Department of Agriculture / Food Safety / Food and Drug Administration / DEPARTMENT OF HEALTH AND HUMAN SERVICES / Department of Health / Food and Drug Administration office of Chief Information officer Paperwork Reduction Act / / /
Position
LACF Registration Coordinator / EDITION IS OBSOLETE President/Vice President / Owner Technologist Manager Director / Director E-mail Address / President /Vice President Signature / /
FORM APPROVED: OMB No[removed]; EXPIRATION DATE: [removed]See PRA statement on page 2.) DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration TYPE OF SUBMISSION