Attachment 01 Performance Work Statement.pdf

PERFORMANCE WORK STATEMENT (PWS)

SERVICE AGREEMENT FOR RADIATION PHYSICS SURVEYS

TABLE OF CONTENTS

SECTION TITLE

1.0 INTRODUCTION

2.0 BACKGROUND

3.0 SCOPE OF WORK

4.0 QUALITY ASSURANCE SURVEILLANCE PLAN

5.0 POSITION DESCRIPTIONS

6.0 APPLICABLE TECHNICAL ORDERS, SPECS, REGULATIONS, AND MANUALS

7.0 ACRONYMS AND DEFINITIONS

1.0. INTRODUCTION.

1.1. The contractor shall provide the services of a Medical Physicist to the Department of Radiology, Guthrie Ambulatory Health Clinic, Bowe Troop Medical Clinic, Marshall Dental Clinic, Stone Dental Clinic, and Veterinary Treatment Facility, all located on Fort Drum, NY which shall contribute to the verification / validation of a safe work environment for staff and patients.

1.2. All services shall be provided in accordance with established standards, principles and ethics of the profession and applicable professional specialty organizations, The Joint Commission (JC) standards, applicable Department of Defense (DoD) and Army specific regulations, directives, and policies, and military treatment facilities (MTF) specific policies, procedures, and job descriptions.

Contract health care providers (contract personnel) shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for Patients. The Contractor shall provide services for varied healthcare specialties in accordance with established principles and ethics of the medical profession, the national standards established by the JC, the professional standards at the military treatment facilities (MTF), and the American Board of applicable specialty. The Contractor shall be held accountable for compliance to the standards listed in the Comprehensive Accreditation Manual for Hospitals (CAMH) dated January 2014 or current version.

2.0 BACKGROUND.

2.1. The mission of the military healthcare system (MHS) is to ensure the nation has, available at all times, a healthy military force supported by a combat ready healthcare system. Health care services for eligible MHS beneficiaries are provided at military treatment facilities (MTF) located on or near military installations or posts. The military treatment facility may be a clinic, Hospital, or Medical Center. Clinics are outpatient facilities offering primary care or simple specialty care (routine exams, tests, treatments).

The Clinic may be a stand-alone site or a satellite of a larger Clinic, Hospital, or Medical Center. Army Community Hospitals (ACH) offer more complex, resource- intensive secondary care (e.g. inpatient care, surgery under anesthesia) and primary care at outpatient clinics inside and outside the hospital. Army Medical Centers (MEDCENs) offer tertiary (sophisticated diagnosis/treatment of any ailment), secondary, and primary care, hospital services, preventive services, blood bank, and other services. In addition, all MEDCENs offer graduate medical education programs for physicians.

2.2. Guthrie Ambulatory Health Clinic is located near Watertown, NY in a region known as the North Country.

The clinic today is unique in that it supports an Army division but has no inpatient capabilities. Its 35,000 beneficiaries receive emergency and inpatient care at local civilian hospitals. Routine care is provided at the main clinic, the Conner Troop Medical Clinic, and the Wilcox Health Clinic.

3.0 SCOPE OF WORK

3.1 Description of Work. The Contractor shall furnish all necessary travel, labor, materials, tools, parts required for inspection, annual radiation safety evaluation (survey) support, repairs, software upgrades, and certified health physicist for veterinary and dental physics testing.

3.2 Services shall be performed for the Guthrie Ambulatory Health Clinic, Healthcare Technology Management section on equipment located at the following locations for equipment type identified in Appendix A:

a. Marshall Dental Clinic, Ft. Drum NY

b. Stone Dental Clinic, Ft. Drum NY

c. Ft. Drum Veterinary Treatment Facility (VTF), Ft. Drum NY

3.3 This contract shall cover the base period of Date of Award through September 30, 2025, with four (4) option years ending 30 September 2029, in accordance with all terms, conditions, provisions, schedules, and specifications of this solicitation.

3.4 Performance Measures.

3.4.1 Outcome. The Contractor shall perform inspections, testing and annual radiological physics surveys as required by Joint Commission (JC), the American College of Radiology (ACR), Food & Drug Administration (FDA) Occupational Safety & Health Administration (OSHA), Army Regulations (MEDCOM 40-42, TB MED 521) and Code of Federal Regulations Title 21 Subpart J that meet or exceed current standards established by JC, ACR, FDA, OSHA.

3.4.2 Standards. Services shall be performed by Contractor who is board certified in Diagnostic Radiology by the American Board of Radiology or equivalent in the appropriate disciplines of radiologic physics, including diagnostic, therapeutic, and/or medical nuclear physics or equal, who demonstrates competency in these disciplines. Certification is to be submitted with proposal.

3.4.3 Measurement Standards. The Contractor shall furnish annual radiographic surveys as indicated noting a separate "Pass-Fail" entry in the report, or for specific instances where the item is not applicable to the make and model of the system being evaluated, a notation of "N/A" (not applicable).

Each failed item shall have a concise explanation of why it failed. For mammography systems, contractor shall include necessary information to fulfill ACR accreditation requirements.

The MTFs, DENTAC and VTFs all use digital image systems to acquire images. Performance requirements shall be in accordance with the ACR standards.

3.5. Qualifications. Matrix of Inspection and Reporting for Diagnostic X-Ray Systems and Measurement of Assessment Criterion are identified at Technical Exhibit A.

3.6 For all routine scheduled inspections, the Contractor shall have at least thirty calendar days’ notice to schedule site-visit. Scheduling shall be coordinated with the GAHC COR at all times prior to notification of site visit to the requiring facility.

3.7 Scheduling of compliance testing shall be conducted at times to be mutually agreed upon by GAHC COR. Survey shall be performed during the months of October, November, April, and May. A written report of this survey and evaluation shall be submitted to the GAHC COR, no later than 2 weeks after survey completion. For all equipment requiring corrective action, or special call-back inspection the GACH COR will coordinate with the contractor for necessary repairs, inspections and/or adjustments as needed. In such cases, the contractor shall provide the inspection within ten calendar days of notification by GAHC COR.

3.8 Special Call -Back Inspections. Due to sudden failure of x-ray equipment and subsequent repairs, it may be necessary to schedule, on short notice, a "special call-back inspection" in order to place the equipment back in service at the earliest possible time. In such cases, the contractor shall provide the inspection within ten calendar days of notification by the Health Physics Officer/COR.

3.9 The Contractor's reporting of defects, and written report generation and submission shall include all MQSA inspections, reports shall be made within the specified times, and specific actions required for defects found as specified by MQSA requirements. Contractor shall provide notification to the GAHC COR one business day of detecting deficiencies in equipment and provide immediate verbal and written notification to the onsite facility clinic personnel of such deficiencies.

3.10 All final written reports shall be submitted to the GAHC COR, and for radiology, a copy of the final written report shall be sent directly to owning facility, within thirty calendar days of the completion of the test. Reports submitted to the GAHC COR shall include summary of deficiencies, a list of all equipment tested including description/model, location, serial number, and equipment control number. Reports shall be submitted electronically in Adobe.pdf format, in hard copy, or both; at the discretion of the contractor.

When requested, the contractor shall provide clarification of reports within thirty calendar days of the request.

3.11 Access to Installation and Facilities: Contractor personnel are required to meet military installation access requirements. This includes personal identification (i.e. a valid current driver's license or other U.S. state government issued identification), and for vehicle operators, having proof of current insurance and vehicle registration or a current and valid vehicle lease/rental contract. Vehicle or personal searches may be required at any time for entry, and during emergency exercises or actual emergencies, access to an installation may be restricted indefinitely with little or no notice. Access to the individual facilities will require personal identification, as well as possible additional access requirements, including issuance of a facility identification card.

3.12 Security.

3.12.1 Security Identification Badges. The Contractor and contract personnel shall comply with the local installation and MTF personnel identification and access requirements while on site. While on site, each contract personnel shall wear visible security badge identification, provided by the military installation or the MTF, on the front of his/her outer clothing. The badge must be visible at all times, and may not be place on accessory items (i.e. backpacks, purses, etc…). The Contractor is responsible for absences of contract personnel due to expired identification and access documents. Such absences shall not relieve the Contractor of its obligation to perform the healthcare services required under this contract. The contract personnel shall immediately report any lost or stolen badges to the COR. The contract personnel shall turn in all identification badges to the COR, or his/her designated representative upon completion of their services.

3.12.2 Safeguarding Material. The contract personnel shall be responsible for safeguarding all Government property. The Contractor shall safeguard information of a confidential or sensitive nature.

All patient related information is considered confidential and sensitive. Contractors are prohibited from reproducing patient information in any way. This includes printing. Neither the Contractor nor any of its contract personnel shall disclose or cause to be disseminated any information concerning the operation of the MTF that could result in or increase the possibility of a breach in security or interrupt the continuity of operations or which breach the requirements of the Federal Privacy Act of 1974. However, the Contractor may be required to provide testimony or disposition in cases of due process action.

3.13 Training.

3.13.1 Annual training requirements. The Contractor shall ensure that contract personnel complete any mandatory annual training requirements in accordance with MTF procedures.

3.14 Access and general protection/security policy and procedures. This standard language is for contractor employees with an area of performance within Army controlled installation, facility, or area.

Contractor and all associated sub-contractors employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements (FAR clause 52.204-9, Personal Identity Verification of Contractor Personnel) as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force

3.6 HOURS OF PERFORMANCE

3.6.1. MTF, DENTAL, and VTF Clinics have designated operating hours from 0730 till 1600, M – F only.

NOTE: Any holidays that are declared by Presidential Executive Order shall be observed in the same manner as the holidays listed above. If the area in which a contract employee is scheduled to work is closed due to the holiday and the employee is not required to report in, payment will not be made for those hours. Closures of the installation due to inclement weather or other such acts of God shall be handled in the same manner.

3.6.2. Closures. During anticipated closure of the facility due to Command declared training holidays or during unplanned closure of the facility due to natural disasters, military emergencies, severe weather, or otherwise, the contractor shall not invoice the Government for services not performed and the Government will not be liable to the contractors for any such closures.

3.6.3 Scheduling process: The services shall be performed at the Department of Radiology, Guthrie Ambulatory Health Clinic, Bowe Troop Medical Clinic, Marshall Dental Clinic, Stone Dental Clinic, and Veterinary Treatment Facility, all located on Fort Drum NY. The contractor shall be scheduled to work Monday through Friday, 40 hours per week between the hours of 0630 through 1530 excluding federal holidays and executive declared holidays. The work schedule includes a 60 minute unpaid meal break.

3.6.4 The COR or their designee will be responsible for communicating with the contractor regarding scheduling dates to perform the contracted obligation.

When the contractor cannot satisfy the requested timeline, the contractor shall notify the COR with a suggested alternate timeline.

Scheduled contract personnel shall be coordinated with the COR at least 30 calendar days in advance of required date. The Contractor will only be paid for hours actually worked.

3.6.5. The Contractor is responsible for submitting an accurate invoice. The Contractor may only invoice and be paid for the services actually rendered. If the Contractor performs fewer services than are provided in the contract schedule, the Government may, at the end of the applicable contract period, deobligate the excess quantities.

3.7 LICENSE VERIFICATION AND CREDENTIALV REVIEW OR P R I V I L E G I N G .

3.7.1 The contractor will follow Army Regulation (AR) 40-68 Clinical Quality Management for all healthcare services provided in the MTFs. Army Regulation 40-68 is located on the internet at website http://www.apd.army.mil/pdffiles/r40_68.pdf.

3.7.2 The contractor shall perform all primary source verifications and include all verifications with the credentials package or competency assessment folder information for non-privileged staff in accordance with AR40- 68. The contractor shall obtain all paperwork, letters of reference, approvals, work history, etc required by the MTF credentialing or licensure verification processes. The MTF staff will not assist the contractor in obtaining any needed information for initial credentialing. The contractor is responsible for the current competence of contract used to provide healthcare services under this contract.

The Contractor shall contact the Credential Office for current credentialing process. The GAHC Credential Office contact numbers are (808) 433-2459 and/or (808) 433-4393.

3.8 Conduct.

3.8.1 Contract personnel shall comply with MTF policies regarding personal appearance and conduct.

4.0 QUALITY ASSURANCE SURVEILLANCE PLAN

4.1. Inspection. The inspection and acceptance point for all services rendered under this contract will be the COR. The performance by the contract personnel, the quality of services rendered, and any documentation or written material in support of same, shall be subject to continuous inspection, surveillance and review for acceptance by the COR. Any services rendered by the contract personnel with military/civilian personnel that is deemed unprofessional, threatening, or dangerous by the COR will be grounds for immediate termination for default or cause.

Personnel Qualifications: The following requirements must be met by the successful contractor:

4.1.1 Personnel responsible for the inspection of x-ray emitting equipment shall provide documentation of their education, training, and experience to include a full or partial list of current facilities where they conduct tests in order to be determined qualified to conduct specified tests. The Quality Management (QM) Department will evaluate the prospective inspector qualifications and based on the information provided and at our discretion, the prospective inspector (s) will either be authorized to conduct the tests, or denied permission to conduct the tests. This will be an on-going assessment, and will be a basis for continued use. The successful contractor shall at any time submit other individuals for evaluation.

4.1.2 The contractor may at their discretion request that personnel in training status be authorized to conduct inspections, but these inspections shall be under the direction and supervision of an individual authorized to conduct the tests. The contractor shall also notify the GAHC QM /COR of their intent to use individuals in training status prior using such individual. At the Government’s discretion we may or may not grant authorization.

4.1.3 For testing any modality that requires specific education, training and experience requirements shall be current, i.e. mammography and stereotatice breast biopsy. The contractor shall submit all required documentation to prove the necessary qualifications and resubmit documentation periodically as required.

5.0. POSITION DESCRIPTIONS.

Medical Physicist

Qualifications

Education: At a minimum a Master Degree or PhD in medical physics or radiation biology from an accredited university. Training in a clinical medical physics obtained through a residency traineeship or a post-doctoral program for one to two years in a hospital. Copy/copies of degree(s) to be submitted for credentialing requirements.

Licensure/Certification/Registration: When possible, medical physicists will also be certified by the presiding Board of their specialty. Certifications or applicable licensure must be valid for the state of NY.

Experience: At a minimum three years’ experience working as a Medical Physicist. Experience must be current.

The Contractor should have experience in the following radiology equipment including:

MRI systems, Ultrasound equipment, Digital Radiographic systems, Radiographic and Fluoroscopic systems, General Radiographic systems, Dental Radiographic systems (Dental Cone Beam CT, PACS components, and Intraoral X-Ray system), and veterinary radiographic systems.

TECHNICAL EXHIBIT A.

Matrix of inspection and Reporting Requirements for Diagnostic X-ray Systems

Measurement or Assessment Criterion

System Applicability

F ix e d

R a d io gr a p hi c

M o bi le

R a di o gr ap hi c

F ix e d

F lu o ro sc op ic

M ob ile F lu or o sc o pi c

R ad io gr ap hi c- F lu o ro gr a ph

R a di o gr a ph ic

-T o m o gr ap hi c

M am m o gr a p hi c

S te re ot ac tic

B re a st

B io ps y

C o m p u te d T om o g ra ph y

B on e D e n si to m et er

D e nt a l l nt ra or al fix e d o r m o bi le

D en ta l P an o gr a ph ic

C e ph al o m e tr ic

, P an

C e p h

Warning Label - 21 CFR 1020.30(j) X X X X X X X X X X X X

Each item listed will have a separate "Pass- Fail" (or the like) entry in the report, or for specific instances where the item is not applicable to the make and model of the system being evaluate, a notation of "not applicable." Each "failed" item will have a concise explanation of why it failed; this may be listed in the report at immediate area of the item, or may be referenced and reported in a summary area of the report. As applicable, other items should be notated with concise descriptive information pertinent to the item.

For mammographic systems, include necessary information to fulfill ACR accreditation requirements.

Technique factor indication X X X X X X X X X X X

Visible beam-on indication X X X X X X X X X X X X

Audible exposure indication X X X X X X X X X X X

Selected tube indication (if more than one tube in the device)

X

Cooling curves or heat calculator X X X X X X X X X X X X

Tube centering over image receptor

Means to indicate when beam axis is perpendicular to image receptor

Exposure termination after preset time interval, mAs, or pulses

Source-to-lmage Distance indication and accuracy

Step-less collimator X X X

AEC-Phototimer indication+ X X X X

Means to terminate exposure at any time

Commented [KC1]: check e d

R a d io gr a p hi c

M o bi le

R a di o gr ap hi c

F ix e d

F lu o ro sc ile F lu or o sc o pi c

R ad io gr ap hi c- F lu o ro gr a di o gr a ph ic

-T o m o gr ap hi c

M am m o gr a p hi c

S te re ot ac tic

B re a st

B io ps y

C o m p u te d T om o g ra hy

B on e D e n si to m nt a l l nt ra or al fix e d o r m o bi le

D en ta l P an o gr a ph ic

C ep h al o m e tr ic

, P an

C e

Cumulative timer not greater than 5 minutes

Audible indicator at tube X X X

Collimator tracks vertical lR movement

Primary barrier transmission X X X

Assessment Criterion

Expected Reporting Documentation e d R a di og ra p o bi le

R a d io gr ap hi c

F ix e d

F lu o ro sc o pi c

M o bi le

F lu or o sc di o gr a p hi c- F lu or og ra di o gr a p hi c- T om og ra m m og ra

S te re o ta ct ic B re a st B io sy

C m p u te d T om o gr ap e D e n si to m e te r

D e nt a l l n tr ao ra l ( fix e d o r M ob ile

D e nt a l P a no g ra p hi c, ph a lo m et ric , P an

C ep h Continuous audible sound when using high- level control

Minimum SSD appropriate for device

Battery charge indication X Six-foot exposure cord X Light Field llluminance Level X X X X X

Report as stated in TB MED 521, including measurement values, acceptance criteria, and whether this passed or failed the acceptance criteria. Add appropriate concise notation for items when necessary.

Note whether the specific item was "not applicable" due to the specific make and model of the system being evaluated.

For mammographic systems, include necessary information to fulfill ACR accreditation requirements.

X-ray Field Alignment X X X X X X PBL Alignment and Functionality X X X Collimation Assessment X X Timer Accuracy X X X X X X X X X X X kVp Accuracy and Reproducibility X X X X X X X X X X mA linearity

X X X X X X X X X X X X Beam Quality

X X X X X X X X X X X X Focal Spot Resolution X X X X Phototimer Evaluation X X X Entrance Skin Exposure X X X X X X X X X X Fulcrum height

X Slice thickness

X Uniformity of motion X

Beam Alignment X X X

High/Low Contrast values X X X

Entrance Exposure Rates X X X

Primary Barrier Transmission Rate

X X X

Focal Spot Performance X X

Automatic Exposure Control (AEC) System Performance

Uniformity of Screen Speed X X ed

R ad io g ra p bi le

R a d io gr ap hi c

F ix ed F lu or o sc o pi c

M o bi le

F lu o ro sc di o gr a ph ic

-F lu or og ra p hi c

R a di o gr a ph ic

-T om o gr a m m og ra p re ot a ct ic B re a st B io m p ut e d T o m o gr ap e D e ns ito m et e r

D e nt al ln tr a or a l ( fix ed o r m ob ile

D e nt al

P an o gr ap ph al o m e tr ic , P an

C e

Phantom lmage Quality Evaluation

X X

Breast Entrance Exposure, Average Glandular Dose and Output Rate

Viewbox Luminance and Room

Digital Receptor Uniformity

X

Localization Accuracy Test

X

Tube Head Leakage

X X X X X X X X X X X X lnclude measurement values preferably on a simple layout diagram of the room. Add appropriate concise notation for items when necessary. Note whether the specific item was "not applicable" due to the specific make and model of the system being evaluated.

Applicable radiation protection standards, when applicable, should be stated, and if results are in excess of these standards, this should be noted.

For mammographic systems, include necessary

Scatter radiation at operator's position

X X X X X X X X X X X X

Scatter radiation at head of table

X X X X X X X

Scatter radiation at foot of table

X X X X X X X

Scatter radiation at Control Booth entry

Scatter radiation at boundary walls to uncontrolled areas, floor, and e d R a d io gr a p hi c

M ob ile R a di o g ra e d

F lu o ro sc ile F lu or o sc o pi c

R a di o gr ap hi c-

F lu o ro gr a di o gr ap hi c-

T o m o g ra p hi c

M am m o gr a p hi c

S te re o ta ct ic B re as t B io ps y

C o m p u te d T om o g ra ph y

B o n e

D e ns ito m e te r

D e nt a l l n tr ao ra l ( fix e d o r m o bi le

D e nt a l P a no g ra ph ic

C e ph a lo m et ri c, P a n-

C ep

Mammography- Stereotactic Breast Biopsy Unit Assembly Evaluation lnclude necessary information to fulfill ACR accreditation requirements for the specific modality.

Artifact Evaluation lf images are obtained during testing of a system (preferably, this should be done), a concise descriptive assessment of any identified artifacts observed should be given. Any deficiencies should be noted, along with specific corrective action recommendations that will return the program to compliance when followed.

lnclude necessary information to fulfill ACR accreditation requirements.

W81K00-14- C- 0014

F ix ed R a d io gr a p hi c

M ob ile R a di o g ra p ed F lu or o sc ile F lu or os co pi c

R ad io gr a ph ic -F lu o ro g ra p hi c

R ad io gr a ph ic -T om o g ra am m og ra p re ot a ct ic B re a st B io ps y

C om pu te d T o m o g ra e D e ns ito m en ta l l nt ra or al fix ed o r m ob ile

D en ta l P an o g ra p h al om et ric , P a n-

C e

Site technologist's QC Program assessment

A concise descriptive assessment of the program should be given. Any deficiencies should be noted, along with specific corrective action recommendations that will return the program to compliance when followed.

lnclude necessary information to fulfill ACR accreditation

Mechanical indexing

Report as stated in TB MED 521, including measurement values, acceptance criteria, and whether this passed or failed the acceptance criteria. Add appropriate concise notation for items when necessary. Note whether the specific item was "not applicable" due to the specific make and model of the system being evaluated.

Table indexing X

Radiation Field Profile: Collimation Accuracy

Gantry Tilt

X

Table lsocenter/Sagittal Alignment Light Congruence lsocenter Alignment

X

Accuracy of Scan Prescription from Scout Localization image lmage Scan Width

X

CT Number Uniformity with typical measured values

Noise X

F ix ed R a d io g ra p hi c

M ob ile R a d io g ra ed F lu or o sc ile F lu or os co pi c

R ad io gr ap h ic -F lu o ro g ra ad io gr ap h ic -T o m o gr ap am m og ra p re ot ac tic

B re a st

B io om pu te d T o m o gr a ph y

B on e D e ns ito m en ta l l nt ra or al fix ed o r m o bi le

D en ta l P a no gr a ph ic

C ep ha lo m et ric

, P an

C

Spatial Resolution (high and low contrast resolution)

CTDl, DLP, and Effective Dose

APPENDIX A.

Equipment List

ECN Customer Name

Nomenclature Manufacture r

Nameplate Model

Mfr. Serial No.

15979 STONE

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PLANMECA

PRO X

IPX012885

25154 STONE

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PRO X-80 IPX036975

13336 STONE

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

INTRA IXRF90437

25149 STONE

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PRO X-80 IPX036972

25150 STONE

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PRO X-80 IPX036978

25112 STONE

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, EXTRAORAL

PLANMECA

USA INC

PRO ONE PROV174794

13331 MARSHALL

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

INTRA IXRF95878

14527 MARSHALL

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PROMAX S3

PANORM

RPX243292

14143 MARSHALL

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

INTRA

ORAL

IXRF87291

25155 MARSHALL

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PRO X-80 IPX036974

25153 MARSHALL

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PRO X-80 IPX036973

25151 MARSHALL

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PRO X-80 IPX036977

25148 MARSHALL

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PRO X-80 IPX036971

25147 MARSHALL

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PRO X-80 IPX036970

25152 MARSHALL

DENTAL CLINIC

RADIOGRAPHIC UNIT,

DENTAL, INTRAORAL

PLANMECA

USA INC

PRO X-80 IPX036976

29350 Veterinary Clinic RADIOGRAPHIC SYSTEM, DIGITAL

INNOVET INNOVET

VERSA

BGB076-0424

19483 Veterinary Clinic RADIOGRAPHIC UNIT, DENTAL, INTRAORAL

Aribex Inc Nomad Pro 2 10035