CRMLN Data Submission Form

NCEH DLS Laboratory Quality Assurance Programs

Att 3c. CRMLN Data Return Form.xlsm

OMB: 0920-1389

Document [xlsx]
Download: xlsx | pdf

Overview

General Infomation
List of samples PS0720
Density
TC-AK
TC-IDMS
TG
HDL-DCM
HDL-LDL


Sheet 1: General Infomation











Unit of measure

CRMLN Network Survey General Information




















Please fill applicable white cells










Please click "enable content" button










Please submit data to [email protected]























Lab ID











Pool Series PS0720








mg/dL

Submission Date (please use calendar)









mmol/L

Unit of Measure (please use drop down) mg/dL










Comment




















































































Sheet 2: List of samples PS0720








































































CRMLN Survey: List of Samples

CRMLN Survey: List of Samples

CRMLN Survey: List of Samples

CRMLN Survey: List of Samples

CRMLN Survey: List of Samples







































































Lab ID 0











Lab ID 0











Lab ID 0











Lab ID 0











Lab ID 0











Survey PS0720











Survey PS0720











Survey PS0720











Survey PS0720











Survey PS0720











Analyte(s) TC TG HDL-DCM











Analyte(s) TC-IDMS TG HDL-DCM











Analyte(s) HDL UC











Analyte(s) HDL/LDL











Analyte(s) HDL/LDL

















































































Location # Analyte Sample Type* PS0720
TC TG HDL-DCM Box Orientation

Location # Analyte Sample Type* PS0720
TC-IDMS TG HDL-DCM Box Orientation

Location # Analyte Sample Type* PS0720
HDL UC Box Orientation

Location # Analyte Sample Type* PS0720
HDL/LDL Box Orientation



Location # Analyte Sample Type* PS0720
HDL/LDL Box Orientation



TC TG HDL-DCM


TC-IDMS TG HDL-DCM


HDL UC


HDL/LDL




HDL/LDL




1 TC CS01

1 2 3 4 5 6


1 TC-IDMS CS01

1 2 3 4 5 6


1 HDL UC CS01

1 2 3 4 5 6


1 HDL/LDL CS01

1 2 3 4 5



1 HDL/LDL CS01 HDL/LDL 1
1 2 3 4 5



2 TC CS02

7 8 9 10 11 12


2 TC-IDMS CS02

7 8 9 10 11 12


2 HDL UC CS01

7 8 9 10 11 12


2 HDL/LDL CS01

6 7 8 9 10



2 HDL/LDL CS01 HDL/LDL 2
6 7 8 9 10



3 TC CS03

13 14 15 16 17 18


3 TC-IDMS CS03

13 14 15 16 17 18


3 HDL UC CS01

13 14 15 16 17 18


3 HDL/LDL CS01

11 12 13 14 15



3 HDL/LDL CS01 HDL/LDL 3
11 12 13 14 15



4 TC CS04

19 20 21 22 23 24


4 TC-IDMS CS04

19 20 21 22 23 24


4 HDL UC CS01

19 20 21 22 23 24


4 HDL/LDL CS01

16 17 18 19 20



4 HDL/LDL CS01 HDL/LDL 4
16 17 18





5 TC NS01

25 26 27 28 29 30


5 TC-IDMS NS01

25 26 27 28 29 30


5 HDL UC CS01

25 26 27 28 29 30


5 HDL/LDL CS02










5 HDL/LDL CS02 HDL/LDL 5









6 TC NS02

31 32 33 34 35 36


6 TC-IDMS NS02

31 32 33 34 35 36


6 HDL UC CS01

31 32 33 34 35 36


6 HDL/LDL CS02










6 HDL/LDL CS02 HDL/LDL 6









7 TC CS01










7 TC-IDMS CS01










7 HDL UC CS01










7 HDL/LDL CS02



7 HDL/LDL CS02 HDL/LDL 7


8 TC CS02










8 TC-IDMS CS02










8 HDL UC CS01



8 HDL/LDL CS02


8 HDL/LDL CS02 HDL/LDL 8

9 TC CS03










9 TC-IDMS CS03










9 HDL UC CS01


9 HDL/LDL CS03


9 HDL/LDL CS03 HDL/LDL 9

10 TC CS04




10 TC-IDMS CS04




10 HDL UC CS01


10 HDL/LDL CS03


10 HDL/LDL CS03 HDL/LDL 10

11 TC NS01



11 TC-IDMS NS01



11 HDL UC CS01


11 HDL/LDL CS03


11 HDL/LDL CS03 HDL/LDL 11

12 TC NS02



12 TC-IDMS NS02



12 HDL UC CS01


12 HDL/LDL CS03


12 HDL/LDL CS03 HDL/LDL 12

13 TG CS01



13 TG CS01



13 HDL UC NS01


13 HDL/LDL NS01


13 HDL/LDL NS01 HDL/LDL 13

14 TG CS02



14 TG CS02



14 HDL UC NS01


14 HDL/LDL NS01


14 HDL/LDL NS01 HDL/LDL 14

15 TG CS03



15 TG CS03



15 HDL UC NS01


15 HDL/LDL NS02


15 HDL/LDL NS01 HDL/LDL 15

16 TG CS04



16 TG CS04



16 HDL UC NS01


16 HDL/LDL NS02


16 HDL/LDL NS01 HDL/LDL 16

17 TG NS01



17 TG NS01



17 HDL UC NS01


17




17 HDL/LDL NS02 HDL/LDL 17

18 TG NS02



18 TG NS02



18 HDL UC NS01


18




18 HDL/LDL NS02 HDL/LDL 18

19 TG CS01



19 TG CS01



19 HDL UC NS01


19










20 TG CS02



20 TG CS02



20 HDL UC NS01


20




*CS: certification Sample, NS: Network Sample




21 TG CS03



21 TG CS03



21 HDL UC NS01














22 TG CS04



22 TG CS04



22 HDL UC NS01


*CS: certification Sample, NS: Network Sample










23 TG NS01



23 TG NS01



23 HDL UC NS01














24 TG NS02



24 TG NS02



24 HDL UC NS01














25 HDL-DCM CS01



25 HDL-DCM CS01



25 HDL UC NS02














26 HDL-DCM CS02



26 HDL-DCM CS02



26 HDL UC NS02














27 HDL-DCM CS03



27 HDL-DCM CS03



27 HDL UC NS02






































28 HDL-DCM CS04



28 HDL-DCM CS04



28 HDL UC NS02






































29












29












29 HDL UC NS02






































30












30












30 HDL UC NS02






































31 HDL-DCM CS01










31 HDL-DCM CS01










31 HDL UC NS02






































32 HDL-DCM CS02










32 HDL-DCM CS02










32 HDL UC NS02






































33 HDL-DCM CS03










33 HDL-DCM CS03










33 HDL UC NS02






































34 HDL-DCM CS04










34 HDL-DCM CS04










34 HDL UC NS02






































35












35












35 HDL UC NS02






































36












36












36 HDL UC NS02












































































































*CS: certification Sample, NS: Network Sample












*CS: certification Sample, NS: Network Sample












*CS: certification Sample, NS: Network Sample


























































































































































































































































Sheet 3: Density
































































Serum Density

















































































































Lab ID 0



Lab ID 0









Lab ID 0









Lab ID 0











Lab ID 0










Survey PS0720




Survey PS0720









Survey PS0720









Survey PS0720











Survey PS0720










Analyte(s) TC TG HDL-DCM



Analyte(s) TC-IDMS TG HDL-DCM









Analyte(s) HDL UC









Analyte(s) HDL/LDL











Analyte(s) HDL/LDL





































































Location # Analyte



Location # Analyte Sample Type*








Location # Analyte Sample Type*








Location # Analyte Sample Type*










Location # Analyte Sample Type*









TC TG HDL-DCM Density, g/mL Mesured or standard


TC-IDMS TG HDL-DCM Density, g/mL Mesured or standard





HDL UC Density, g/mL Mesured or standard





HDL/LDL Density, g/mL Mesured or standard







HDL/LDL Density, g/mL Mesured or standard






1 TC CS01 0







1 TC-IDMS CS01 0







1 HDL UC CS01 0







1 HDL/LDL CS01 0









1 HDL/LDL CS01 HDL/LDL 1








2 TC CS02 0







2 TC-IDMS CS02 0







2 HDL UC CS01 0







2 HDL/LDL CS01 0









2 HDL/LDL CS01 HDL/LDL 2








3 TC CS03 0







3 TC-IDMS CS03 0







3 HDL UC CS01 0







3 HDL/LDL CS01 0









3 HDL/LDL CS01 HDL/LDL 3








4 TC CS04 0







4 TC-IDMS CS04 0







4 HDL UC CS01 0







4 HDL/LDL CS01 0









4 HDL/LDL CS01 HDL/LDL 4








5 TC NS01 0







5 TC-IDMS NS01 0







5 HDL UC CS01 0







5 HDL/LDL CS02 0









5 HDL/LDL CS02 HDL/LDL 5








6 TC NS02 0







6 TC-IDMS NS02 0







6 HDL UC CS01 0







6 HDL/LDL CS02 0









6 HDL/LDL CS02 HDL/LDL 6








7 TC CS01 0







7 TC-IDMS CS01 0







7 HDL UC CS01 0







7 HDL/LDL CS02 0









7 HDL/LDL CS02 HDL/LDL 7








8 TC CS02 0







8 TC-IDMS CS02 0







8 HDL UC CS01 0







8 HDL/LDL CS02 0









8 HDL/LDL CS02 HDL/LDL 8








9 TC CS03 0







9 TC-IDMS CS03 0







9 HDL UC CS01 0







9 HDL/LDL CS03 0









9 HDL/LDL CS03 HDL/LDL 9








10 TC CS04 0







10 TC-IDMS CS04 0







10 HDL UC CS01 0







10 HDL/LDL CS03 0









10 HDL/LDL CS03 HDL/LDL 10








11 TC NS01 0



Measured


11 TC-IDMS NS01 0







11 HDL UC CS01 0







11 HDL/LDL CS03 0









11 HDL/LDL CS03 HDL/LDL 11








12 TC NS02 0



Standard


12 TC-IDMS NS02 0







12 HDL UC CS01 0







12 HDL/LDL CS03 0









12 HDL/LDL CS03 HDL/LDL 12








13 TG CS01 0







13 TG CS01 0







13 HDL UC NS01 0







13 HDL/LDL NS01 0









13 HDL/LDL NS01 HDL/LDL 13








14 TG CS02 0







14 TG CS02 0







14 HDL UC NS01 0







14 HDL/LDL NS01 0









14 HDL/LDL NS01 HDL/LDL 14








15 TG CS03 0







15 TG CS03 0







15 HDL UC NS01 0







15 HDL/LDL NS02 0









15 HDL/LDL NS01 HDL/LDL 15








16 TG CS04 0







16 TG CS04 0







16 HDL UC NS01 0







16 HDL/LDL NS02 0









16 HDL/LDL NS01 HDL/LDL 16








17 TG NS01 0







17 TG NS01 0







17 HDL UC NS01 0







17












17 HDL/LDL NS02 HDL/LDL 17








18 TG NS02 0







18 TG NS02 0







18 HDL UC NS01 0







18












18 HDL/LDL NS02 HDL/LDL 18








19 TG CS01 0







19 TG CS01 0







19 HDL UC NS01 0







19

























20 TG CS02 0







20 TG CS02 0







20 HDL UC NS01 0







20












*CS: certification Sample, NS: Network Sample











21 TG CS03 0







21 TG CS03 0







21 HDL UC NS01 0


































22 TG CS04 0







22 TG CS04 0







22 HDL UC NS01 0







*CS: certification Sample, NS: Network Sample

























23 TG NS01 0







23 TG NS01 0







23 HDL UC NS01 0


































24 TG NS02 0







24 TG NS02 0







24 HDL UC NS01 0


































25 HDL-DCM CS01 0







25 HDL-DCM CS01 0







25 HDL UC NS02 0


































26 HDL-DCM CS02 0







26 HDL-DCM CS02 0







26 HDL UC NS02 0


































27 HDL-DCM CS03 0







27 HDL-DCM CS03 0







27 HDL UC NS02 0


































28 HDL-DCM CS04 0







28 HDL-DCM CS04 0







28 HDL UC NS02 0


































29 0 0 0







29

0







29 HDL UC NS02 0


































30 0 0 0







30

0







30 HDL UC NS02 0


































31 HDL-DCM CS01 0







31 HDL-DCM CS01 0







31 HDL UC NS02 0


































32 HDL-DCM CS02 0







32 HDL-DCM CS02 0







32 HDL UC NS02 0


































33 HDL-DCM CS03 0







33 HDL-DCM CS03 0







33 HDL UC NS02 0


































34 HDL-DCM CS04 0







34 HDL-DCM CS04 0







34 HDL UC NS02 0


































35 0 0 0







35

0







35 HDL UC NS02 0


































36 0 0 0







36

0







36 HDL UC NS02 0

































































































*CS: certification Sample, NS: Network Sample










*CS: certification Sample, NS: Network Sample










*CS: certification Sample, NS: Network Sample


































































































































































































































Sheet 4: TC-AK






CRMLN Network Survey Total Cholesterol Abell-Kendal Data Submission





Analyte TC-AK
Please fill applicable white cells
Lab ID 0
Pool Series PS0720
Unit of Measure mg/dL










Day 1


Run date mm/dd/yyyy







Sample Type Sample # Sample ID Rep 1 (mg/dL) Rep 2 (mg/dL)
Certification Samples CS01 0

CS02 0

CS03 0

CS04 0

Network Samples NS01 0

NS02 0











Day 2


Run date mm/dd/yyyy







Sample Type Sample # Sample ID Rep 1 (mg/dL) Rep 2 (mg/dL)
Certification Samples CS01 0

CS02 0

CS03 0

CS04 0

Network Samples NS01 0

NS02 0











Comment






Sheet 5: TC-IDMS






CRMLN Network Survey Total Cholesterol IDMS Data Submission





Analyte TC-IDMS
Please fill applicable white cells
Lab ID 0
Pool Series PS0720
Unit of Measure mg/dL










Day 1


Run date mm/dd/yyyy







Sample Type Sample # Sample ID Rep 1 (mg/dL) Rep 2 (mg/dL)
Certification Samples CS01 0

CS02 0

CS03 0

CS04 0

Network Samples NS01 0

NS02 0











Day 2


Run date mm/dd/yyyy







Sample Type Sample # Sample ID Rep 1 (mg/dL) Rep 2 (mg/dL)
Certification Samples CS01 0

CS02 0

CS03 0

CS04 0

Network Samples NS01 0

NS02 0











Comment






Sheet 6: TG










CRMLN Network Survey Total Glycerol Data Submission









Analyte TG
Please fill applicable white cells
Lab ID 0
Pool Series PS0720
Unit of Measure mg/dL
























Day 1






Run date mm/dd/yyyy
TG: Total Glycerides
FG: Free Glycerol
NG: Net Glycerides









Sample Type Sample # Sample ID TG Rep 1 (mg/dL) TG Rep 2 (mg/dL) FG Rep 2 (mg/dL) FG Rep 2 (mg/dL) NG Rep 2 (mg/dL) NG Rep 2 (mg/dL)
Certification Samples CS01 0





CS02 0





CS03 0





CS04 0





Network Samples NS01 0





NS02 0























Day 2






Run date mm/dd/yyyy
TG: Total Glycerides
FG: Free Glycerol
NG: Net Glycerides









Sample Type Sample # Sample ID TG Rep 1 (mg/dL) TG Rep 2 (mg/dL) FG Rep 2 (mg/dL) FG Rep 2 (mg/dL) NG Rep 2 (mg/dL) NG Rep 2 (mg/dL)
Certification Samples CS01 0





CS02 0





CS03 0





CS04 0





Network Samples NS01 0





NS02 0























Comment










Sheet 7: HDL-DCM






CRMLN Network Survey HDL-DCM Data Submission





Analyte HDL-DCM
Please fill applicable white cells
Lab ID 0
Pool Series PS0720
Unit of Measure mg/dL










Day 1


Run date mm/dd/yyyy







Sample Type Sample # Sample ID Rep 1 (mg/dL) Rep 2 (mg/dL)
Certification Samples CS01 0

CS02 0

CS03 0

CS04 0






Day 2


Run date mm/dd/yyyy







Sample Type Sample # Sample ID Rep 1 (mg/dL) Rep 2 (mg/dL)
Certification Samples CS01 0

CS02 0

CS03 0

CS04 0






Comment






Sheet 8: HDL-LDL













CRMLN Network Survey HDL/LDL Data Submission (5 mL vials)












Analyte HDL/LDL
Please fill applicable white cells
Please use drop down for Sample IDs
Lab ID 0
Pool Series PS0720
Unit of Measure mg/dL
























Day 1









Run date mm/dd/yyyy





















Sample Type Vial # Prep Sample ID (Please use drop down for Sample IDs) BF Rep 1 (mg/dL) BF Rep 2 (mg/dL) HDL Rep 1 (mg/dL) HDL Rep 2 (mg/dL) LDL Rep 1 (mg/dL) LDL Rep 2 (mg/dL)
Certification Samples CS01 1








CS01 2








CS02 1








CS02 2








CS03 1








CS03 2








Network Samples NS01 1








NS01 2








NS02 1








NS02 2
































Day 2









Run date mm/dd/yyyy





















Sample Type Vial # Prep Sample ID (Please use drop down for Sample IDs) BF Rep 1 (mg/dL) BF Rep 2 (mg/dL) HDL Rep 1 (mg/dL) HDL Rep 2 (mg/dL) LDL Rep 1 (mg/dL) LDL Rep 2 (mg/dL)
Certification Samples CS01 1








CS01 2








CS02 1








CS02 2








CS03 1








CS03 2








Network Samples NS01 1








NS01 2








NS02 1








NS02 2
































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