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TECHNICAL SPECIFICATION SUBMITTAL Worm gear drive screw hose clamp Job Name Date PASCO Specialty & Mfg., Inc. 11156 Wright Road Lynwood, CA 90262 Phone (310) 5377782 Fax (800) 7372726 Model Specified
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It is a form used to report specialized medical services.
Healthcare providers who offer specialized medical services are required to file this form.
The form must be completed with information regarding specialized medical services provided.
The purpose is to document and report specialized medical services for regulatory compliance.
Information regarding the types of specialized medical services provided and number of patients treated.
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