To export drug to the United States, Drug Establishment Registration is required. The FDA accepts the facility address from the DUNS database. To begin the procedure, please upload the DUNS number and address proof next page.

Name *

Full Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

FDA Registration Number

DUNS Number *

For more details visit the First page.

DUNS Number & Address Proof - Upload here >

Click or drag a file to this area to upload.

Contact Person Name *

Job Title *

Email *

Phone No *

Other (explain)

Drug Name

Active Ingrediant 1

Assay Value / %

Active Ingrediant 2

Assay Value / %

Name the Person Submitting the Form *

Email *

Drug Establishment Registration Form