SourceMark

Basic Information

• Brand Name: SourceMark
• Primary DI: 00813799005053
• Version / Model: M1204
• Company Name: SOURCEMARK, LLC.
• Labeler DUNS: 121225812
• Distribution Status: In Commercial Distribution
• Device Count in Pkg: 1
• Record Status: Published
• Publish Date: 2020-07-09
• Public Version: 1
• Public Version Date: 2020-07-17
• Public Version Status: New
• Public Device Record Key: 96890772-9846-4869-8958-79f90a9567d8

Device Characteristics

• Single Use: Yes
• Prescription Use (Rx): No
• Over the Counter (OTC): No
• Kit: No
• Combination Product: No
• HCT/P: No
• Contains NRL: No
• Not Made with NRL: No
• MRI Safety: Labeling does not contain MRI Safety Information
• Direct Marking Exempt: No
• PM Exempt: No
• Has Serial Number: No
• Has Lot/Batch Number: Yes
• Has Manufacturing Date: Yes
• Has Expiration Date: Yes
• Has Donation ID: No

Sterilization

• Is Sterile: Yes
• Sterilization Prior Use: No

Product Codes

Code	Name	Medical Specialty	Regulation #	Device Class
MPN	Tissue Adhesive For The Topical Approximation Of Skin	General, Plastic Surgery	878.4010	2

GMDN Terms

Code	Name	Definition	Implantable	Status
35254	General-purpose patient temperature probe, single-use	A temperature sensing device intended to be placed into a body orifice or on the body surface, and used in conjunction with a separate parent device with a display (e.g., electronic patient thermometer, infant warmer) to enable measurement/monitoring of a patient’s temperature; its use is not dedicated to a specific type of procedure. It is typically constructed of flexible materials (e.g., plastic or rubber) with a metal conducting core; the distal end of different device types will be designed for a particular application site. This is a single-use device.	No	Active

Identifiers

Type	ID	Issuing Agency	Package Type	Qty per Pkg	Pkg Status	Pkg Discontinue Date
Package	10813799005067	GS1	Box	12	In Commercial Distribution
Primary	00813799005053	GS1
Package	20813799005071	GS1	Case	6	In Commercial Distribution

Premarket Submissions

Submission Number	Supplement Number
K132243	000