CLSI LockBox

PO Box 645766
PITTSBURGH, PA 15264-5255
United States

Customer #: 001045747I Invoice

Ronald Chambi Terrazas Invoice #: 377544
CNS
PO#:
Cochabamba Hospital
Avenida Suecia / pasaje 23 Nº 2978 Invoice Date: 02/20/2019
Cerado, C 591
BOLIVIA Due Upon Receipt

Description Quantity Price Discount Amount

EP05A3E Evaluation of Precision of Quantitative Measurement 1 $180.00 $0.00 $180.00
Procedures, 3rd Edition
EP12A2E User Protocol for Evaluation of Qualitative Test 1 $180.00 $0.00 $180.00
Performance, 2nd Edition
EP19Ed2E A Framework for Using CLSI Documents to 1 $0.00 $0.00 $0.00
Evaluate Clinical Laboratory Measurement Procedures, 2nd
Edition

This is a Pro Forma Invoice Invoice Total $360.00

Taxes $0.00
Amount Paid $0.00
PLEASE PAY $360.00

PLEASE DETACH AND REMIT WITH YOUR PAYMENT

Invoice#: 377544 Select Payment Method

Customer #: 001045747I Check Enclosed CVV ________

Card Provider ___________________ Exp Date____/____

Ronald Chambi Terrazas
CNS Card #___________________________________________
Cochabamba Hospital Card Holder's Name________________________________
Avenida Suecia / pasaje 23 Nº 2978
Cerado, C 591 Card Holder's Signature_____________________________
BOLIVIA

Remit Payment To:

CLSI LockBox Total Due: $360.00

PO Box 645766 Amt Remitted :
PITTSBURGH, PA 15264-5255
United States
(P) 6106880100 (F) 6106880700
(E) customerservice@clsi.org