Get Ca Cdph 72r 2013-2025

The CA CDPH 72R is the biennial medical device manufacturing license renewal application required by the California Department of Public Health. This guide offers clear steps for completing the form online, ensuring all necessary information is provided accurately to avoid delays in processing.

Follow the steps to complete your application seamlessly.

1. Press the ‘Get Form’ button to obtain the application and open it in an appropriate editor.
2. Enter the legal name of your firm in the designated field.
3. Provide any 'Doing Business As' names in the appropriate area.
4. Fill out the facility address, including the number, street, city, state, and ZIP code.
5. If different, complete the mailing address with all required details.
6. Enter the full name and title of the facility operator responsible for manufacturing.
7. Input the facility's business telephone number.
8. List the facility's FAX number.
9. Provide a 24-hour emergency contact number.
10. Include your facility's email address.
11. Identify the correspondent who will handle inquiries regarding this application.
12. Fill in the correspondent's business telephone number and FAX number.
13. Enter the county where your facility is located.
14. Input your company's website URL.
15. Indicate your involvement in interstate commerce by marking the appropriate boxes.
16. Choose the type of ownership that applies to your facility.
17. If applicable, provide the corporate name and state of incorporation.
18. List names and titles of the owners or officers of the business.
19. Select the types of manufacturing business being conducted at the facility.
20. Check the relevant stage of manufacture for your products at the time of application.
21. Indicate all intended destinations for your manufactured devices.
22. Select applicable product areas for the devices you manufacture.
23. List the types of classified and unclassified devices manufactured, specifying their federal classification.
24. Identify manufacturing processes and indicate whether they are in-house or contracted.
25. Complete the payment section, including the total payment due.
26. Attach the required documents as specified in the application guidelines.
27. Sign the application, print your name and title, and date the document.
28. Finalize by saving changes, downloading, printing, or sharing the completed form.

Complete your CA CDPH 72R application online today for a smooth renewal process.