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Sample Submission
1. Sample Submission
2. Test Requested
3. Results & Billing
Sample Matrix
*
API
Capsule
Chew
Cream
Gel
Injectable - Oil
Injectable - Solution
Injectable - Suspension
IV Solution
Lyophilized Vial
Nasal Spray
Ointment
Ophthalmic - Solution
Ophthalmic - Suspension
Paste
Pellet
Powder
Suppository
Suspension
Tablet
Trituration
Trochee
(other)
Other Sample Matrix
*
Formulation Name
Active (API)
*
Concentration
*
Measurement
*
mg
mcg
ng
gm
u
%
(other)
Other Measurement
*
Volume
*
mL
L
mg
gm
(other)
Other Volume
*
Another Active in Sample (2)?
Yes
No
Active (2)
*
Concentration (2)
*
Measurement (2)
*
mg
mcg
ng
gm
u
%
(other)
Other Measurement (2)
*
Volume (2)
mL
L
mg
gm
(other)
Other Volume (2)
*
Another Active in Sample (3)?
Yes
No
Active (3)
*
Concentration (3)
*
Measurement (3)
*
mg
mcg
ng
gm
u
%
(other)
Other Measurement (3)
*
Volume (3)
*
Other Volume (3)
*
Another Active in Sample (4)?
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