DUNS number - This is mandatory, if you do not know the DUNS number mention 123456789 and we will search if your company already has a DUNS number

Address of the manufacturing facility

Address Line 2

City

State/Region/Province

Postal / Zip Code

Country

If you want to add different corporate address then please add then please complete the below section.

Registrant Information (Parent company name, head qurters)

DUNS Number

Address

Address Line 2

City

State/Region/Province

Postal / Zip Code

Country

	API MANUFACTURE
	DISTRIBUTES DRUG PRODUCTS UNDER OWN PRIVATE LABEL
	FDF MANUFACTURE
	HUMAN DRUG COMPOUNDING OUTSOURCING FACILITY
	IMPORT
	LABEL
	MANUFACTURE
	OUTSOURCING ANIMAL DRUG COMPOUNDING
	PACK
	RELABEL
	REPACK

	Compounding from bulk ingredient
	Contract manufacturing
	Contract manufacturing for human over-the-counter drug products produced under a monograph
	Distributes human prescription drug products
	Distributes human over-the-counter drug products
	Intent to compound 506E (drug shortage) drugs
	Manufactures animal prescription drug products
	Manufactures animal over-the-counter drug products
	Manufactures animal over-the-counter Type A medicated article drug products
	Manufactures human over-the-counter drug products not produced under an approved drug application or under a monograph
	Manufactures human over-the-counter drug products produced under a monograph
	Manufactures human over-the-counter drug products produced under an approved drug application
	Manufactures human prescription drug products
	Manufactures Non-Generics

	ANALYSIS
	API/FDF ANALYTICAL TESTING
	API MANUFACTURE
	DISTRIBUTES DRUG PRODUCTS UNDER OWN PRIVATE LABEL
	FDF MANUFACTURE
	HUMAN DRUG COMPOUNDING OUTSOURCING TESTING
	LABEL
	MANUFACTURE
	PACK
	RELABEL
	REPACK

	Compounding from bulk ingredient
	Contract manufacturing
	Contract manufacturing for human over-the-counter drug products produced under a monograph
	Distributes human prescription drug products
	Distributes human over-the-counter drug products
	Intent to compound 506E (drug shortage) drugs
	Manufactures animal prescription drug products
	Manufactures animal over-the-counter drug products
	Manufactures animal over-the-counter Type A medicated article drug products
	Manufactures human over-the-counter drug products not produced under an approved drug application or under a monograph
	Manufactures human over-the-counter drug products produced under a monograph
	Manufactures human over-the-counter drug products produced under an approved drug application
	Manufactures human prescription drug products
	Manufactures Non-Generics