empanelment of drug testing laboratories - Kerala Medical Services ...

DETAILS OF LABORATORY
Name of the Laboratory :
Full Address :
Registration details :
Place of business :
Phone No :
Fax :
E-mail :
Branches & their Address :
Date of Inspection :
License No. & Date :
Issued by :
Valid up to :
Details of testing activity :
Clients List :
Name of the authorized signatory :
Specimen Signature of the authorized
Signatory :
Specimen Signature of the officer who
is authorized to sign the test reports :
ANNEXURE-VII
Ref. Clause No.5.10.18
ANNEXURE-VIII
KMSCL: EOI for Empanelment of Drug testing Laboratories Page 45