FDA Registration Certificate (Tampa, FL)

A sample of content in this file:

FDA information collection OMB Control number: 0910-0543, expiration date: 08/31/2026 Page 1 of 2 FEI: 3000206983 Devices: ESTABLISHMENT REGISTRATION AND LISTING FOR HUMAN CELLS, DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS DESCRIBED IN 21 CFR 1271.10 Reason For Last Submission: Change in Information Last Annual Registration Year: 2024 Last Registration Receipt Date: 12/13/2023 Summary Report Print Date: 12/15/2023 Donor Type(s) Recover Screen Donor Testing Package Process Store Label Distribute Date of Discontinuance Date of Resumption Amniotic Membrane Blood Vessel Bone Cardiac Tissue - non-valved Cartilage Cornea Dura Mater Embryo Fascia Heart Valve HPC Apheresis HPC Cord Blood Ligament Nerve Tissue Oocyte Ovarian Tissue Pancreatic Islet Cells - autologous Parathyroid Pericardium Peripheral Blood Mononuclear Cells Peritoneal Membrane Sclera Semen Skin Tendon Testicular Tissue Tooth Pulp Umbilical Cord Tissue Satellite Recovery Establishment: Parent Manufacturing Establishment FEI No.: No Note: FDA acceptance of an establishment registration and HCT/P listing does not constitute a determination that an establishment is in compliance with applicable rules and regulations or that the HCT/P is licensed or approved by FDA (21 CFR 1271.27(b)). Proprietary Name(s) Establishment Functions HCT/P(s) FEI: 3000206983 Legal Name: Lions World Vision Institute Testing For Micro-Organisms Only: No FOOD AND DRUG ADMINISTRATION Blood: Drugs: Other FDA Registrations: Legal Name and Location: 1410 North 21st Street Lions World Vision Institute Tampa, Florida 33605 USA Phone: 813-289-1200 Ext.: Reporting Official: Amandea Ridley-Dabney, Manager of Quality & Regulatory Affairs 1410 North 21st Street Tampa, Florida 33605 USA Phone: 813-289-1200 Ext. 310 amandea.r-dabney@lwvi.org