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U.S. Department of Health and Human Services

510(k) Premarket Notification
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Device Classification Name Mask, Surgical
510(k) Number K221272
Device Name Medical Face Mask
Applicant
Shandong Xingyu Gloves Co., Ltd.
#2189 Yaoqian Rd., Gaomi Economic Development Zone
Weifang,  CN
Applicant Contact Carrie Li
Correspondent
Shanghai Sungo Management Consulting Company Limited.
14th Floor, 1500# Central Ave.
Shanghai,  CN 200122
Correspondent Contact Jarvis Wu
Regulation Number878.4040
Classification Product Code
FXX  
Date Received05/02/2022
Decision Date 06/28/2022
Decision Substantially Equivalent (SESE)
Regulation Medical Specialty General & Plastic Surgery
510k Review Panel General Hospital
Summary Summary
Type Traditional
Reviewed by Third Party No
Combination Product No
Predetermined Change
Control Plan Authorized		 No
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