QCP - Quality Control Program - Enrollment Form ... - HORIBA

QCP - Quality Control Program - Enrollment Form

Please complete the information requested below and FAX to: (949) 341-0752

Laboratory Name: x

Customer Number: x

User Name/Title:

x

Email Address: x Phone Number: x

FAX Number: x

Address: x

City/State/ZIP: x

HEMATOLOGY

Instrument Model: x

Serial Number: x Software Version: x

Controls Used: x

x

Controls Used: x

x

HEMATOLOGY

Instrument Model: x

Serial Number: x Software Version: x

Controls Used: x

x

Controls Used: x

x

Questions about QCP may be addressed to: info.medical@us. or to the above FAX number (Attn: Laboratory Quality Manager).

FCD-0288 Rev.2.doc

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