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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 K211520
Device Name Amerishield Surgical Mask
Applicant
PremiumEStore, LLC
2601 Reliance Drive
Suite 102
virginia beach,  VA  23452
Applicant Contact brent dillie
Correspondent
REGULATORY TECHNOLOGY SERVICES, LLC
1000 Westgate Drive,
Suite 510k
saint paul,  MN  55114
Correspondent Contact prithul bom
Regulation Number878.4040
Classification Product Code
FXX  
Date Received05/17/2021
Decision Date 06/15/2021
Decision substantially equivalent (SESE)
Regulation Medical Specialty General & Plastic Surgery
510k Review Panel General Hospital
Type Traditional
Reviewed by Third Party Yes
Combination Product No
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