Oxygen Gas [Rice Home Medical Llc] -

OXYGEN GAS [RICE HOME MEDICAL LLC]
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NDC	58977-001-01, 58977-001-02, 58977-001-03, 58977-001-04, 58977-001-05, 58977-001-06
Set ID	d6561a52-84b9-41cb-9a39-cf25a26c8060
Category	HUMAN PRESCRIPTION DRUG LABEL
Packager	Rice Home Medical LLC
Generic Name
Product Class
Product Number
Application Number

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OXYGEN PURITY TAG

LOT NUMBER____ SERIAL NUMBER________ AMOUNT_____________ INS. LBS GALS LITERS CU FT

USP TESTS

TEST           ID        ODOR        ASSAY

LIMITS        OK        NONE        GREATER THAN OR EQUAL TO 99.2%

RESULTS __        _____            _______

FOR CUSTOMER USE TO DOCUMENT TESTS PERFORMED ON THIS VESSEL

METHOD OF ANALYSIS IS THE PARAMAGNETIC OXYGEN ANALYZER

MANUFACTURER __________ MODEL ________ CUSTOMER WITNESSED TESTS YES__ MO___ SUPPLIERS SIGNATURE _____________ DATE____ CUSTOMER'S SIGNATURE___________ DATE___________

LIQUID OXYGEN DELIVERY TAG THIS VESSEL CONTAINS OXYGEN U.S.P. (SEE REVERSE SIDE FOR TEST RESULTS) OXYGEN PRODUCED BY THE AIR LIQUEFACTION PROCESS - MEDICAL GASES
PRODUCT WARNINGS

THIS VESSEL CONTAINS OXYGEN U.S.P. (SEE REVERSE SIDE FOR TEST RESULTS) OXYGEN PRODUCED BY THE AIR LIQUEFACTION PROCESS.

INGREDIENTS AND APPEARANCE

OXYGEN
oxygen gas

Ingredient Name	Basis of Strength	Strength
Active Ingredient/Active Moiety
OXYGEN (UNII: S88TT14065) (OXYGEN - UNII:S88TT14065)	OXYGEN	99 L in 100 L

#	Item Code	Package Description
Packaging
1	NDC:58977-001-01	21 L in 1 DEWAR
2	NDC:58977-001-02	31 L in 1 DEWAR
3	NDC:58977-001-03	36 L in 1 DEWAR
4	NDC:58977-001-04	41 L in 1 DEWAR
5	NDC:58977-001-05	46 L in 1 DEWAR
6	NDC:58977-001-06	169 L in 1 DEWAR

Marketing Category	Application Number or Monograph Citation	Marketing Start Date	Marketing End Date
Marketing Information
unapproved medical gas		01/01/1998

Labeler - Rice Home Medical LLC (603626920)

Registrant - Rice Home Medical LLC (603626920)

Name	Address	ID/FEI	Business Operations
Establishment
Rice Home Medical LLC		603626920	manufacture

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