Republic of the Philippines
Department of Health
National Kidney and Transplant Institute
Department of Pathology and Laboratory Medicine
The National Reference Laboratory for Hematology
National External Quatity Assessment Scheme in Hematology for the year 2018
Dear Participant,
The National Kidney and Transplant lnstitute (NKTI) National Reference Laboratory (NRL) for Hematology
will be in its 11th year of implementing the National External Quality Assessment Scheme (NEQAS) in
Blood Gount on 2018. This annual quality assurance program aims to help laboratories attain accurate
and reliable analytical results and achieve inter-laboratory comparability as well. By virtue of the
Department of Health (DOH) Administrative Order No. 2007-0027 dated August 22, 2007 (Revised
Rules and Regulations Governing the Licensure and Registration of Clinical Laboratories in the
Philippines), participation in this scheme is one of the requirements for the renewal of the License to
Operate (LTO) of clinical laboratories of all categories.
As per DOH Department Memorandum no. 2009-00868 issued in September 8, 2014, we shall be
charging a participation fee of three thousand and five hundred pesos (Php 3.500.00) to defray costs
of reagents, supplies, and other operating expenses. Payment may be paid in-cash or in check payable to
National Kidney and Transplant lnstitute via the NKTI cashier or through a deposit to its bank account
using the following details:
AccountName: National Kidney and Transplant lnstitute-Special Project-
AccountNumber: Current Account # A232-1086-22
Bank Name: Landbank West Avenue Branch, Quezon City
Note: For payments made through bank deposit, kindly send us the original deposit slip and indicate the
BANK BRANCH where the transaction was done.
We will be accepting registrations beginning Januarv 2. 2018 until Mav 31. 2018. We appeal to the
laboratories to register as early as possible despite the extension until the month of May, to facilitate the
public bidding process for the NEQAS samples and hence, the timely distribution of the packages to the
participants. Before we start with the bidding process, it will be critical for us to first determine the total
number of laboratories that will register for the year's cycle, especially since we will most likely be
implementing an online / web-based information system starting 2018.
Please submit to us your duly accomplished registration documents through courier mail or personal
deliverv to the NRL office (Mondays to Fridays, 8:00 A.M. to 5:00 P.M.). We will not accept documents
sent through electronic mail or fax.
For questions or concerns, you may contact Ms. Joanna M. Francisco or Mr. Noel T. Segovia through
981 -0300 local 1'l 51 or 0998549021 5 or nrl.n kti.hematology@gmail.com.
Thank you.
Sincerely yours,
h/N^J
PAMELA R. DELAS REYES, MD, DPSP
Coordinator, National Reference Laboratory
National Kidney and Transplant lnstitute
Noted by:
ARNOLD J DEZ, MD, FPSP
National Kidney and Transplant lnstitute
Republic of the Philippines
Department of Health
National Kidney and Transplant Institute
Deparment of Pathology and Laboratory Medicine
The National Reference Laboratory For Hematology
National External Quality Assessment Scheme (NBQAS) in Hematology for the year 2018
.bRRnclpRNT No.:
EW PARTICIPANT: E
Name of Glinical Laboratory:
Mailing Address:
Street no. Street name Barangay
Municipality / City Zip Code Region
. Tel. No.: Lab. Mobile No.: Lab. Email Add.:
Contact Person (1):
Tel. No.: Mobile No.:
Contact Person (2):
Tel. No.: Mobile No.: Email
Category/Classification: E Hospital-Based E Government f,l t"rti"t
f,l rree-Standing ff Priuat" E r""ono"t
E Otn"r, (i.e. RHU, CHO, SHC, etc.;: fl prir"ry
Name of Director/Chief of Hospital/Owner:
Name of Head Pathologist:
Name of Chief Med. Tech.:
Gomplete Blood Count Parameters:
Automated anual Analyzer and reagent brand name
tr
tr
Hemoglobin tl tl
u
Hematocrit tr f,
tl
RBC Count
tr tr
f
WBC Count tr tr
Platelet Count tl tl
Republic of the philippines
Department of Health
National Kidney and Transplant Institute
Department of Pathology and Laboratory Medicine
The National Reference Laboratory for Hematology
National External Quality Assessment Scheme in Hemaiology
PAYMENT SLIP
*Participant No.:
*Name of Laboratory:
*Address:
MODE OF PAYMENT (Please CHECKappropriate box):
The amount of PHP 3,500:
n has been paid directly to NKTI Cashier
* has been deposited to:
Account Name: NATIONAL KIDNEY AND TRANSPLANT INSTITUTE-SPECIAL PROJECT
Current Acct No. : 0232-1086-22
Branch: LANDBANK West Avenue Branch, euezon City
Note: indicate in the original deposit slip the BANK BRANCH wheie transaction was
done.
fk is enctosed as a check(3[ayable to *re rv,tirolq,tr, KIDNEy AND TRAI\il;;"ffi
i*rirrurn
Check No. Bank:
NOTE:
1' Please fill up and return this form, the original Dgposit Slip, and your filled
out NRL-NKTI Hemaiology NEeAS Registration Form to the
National Reference Laboratory for Hematology, Nitional Kidney & Transplant Institute,
COPIES FOR YOUR RECORDS.
East Avenue, Diliman,
Quezon city. pLEASE KEE'
2. The Official Receipt will be delivered together with your EeAS Sample.
3. Personal checks WILL NOT BE ACCEPTED.
Y Republic of the phitippines
Department of Health
National Kidney and Transplant Institute
Department of Pathology and Laboratory Medicine
The National Reference Laboratory for Hematology
National External Quality Assessment Scheme in Hemalology
PAYMENT SLIP
*Participant No.:
*Name of Laboratory:
*Address:
MODE OF PAYMENT (Please CHECKappropriate box):
The amount of PHP 3,500:
m has been paid directly to NKTI Cashier
* has been deposited to:
Account Name: NATIONAL KIDNEY AND TRANSPLANT INSTITUTE.SPECIAL PROJECT
Current Acct No. : 0232-t086-22
Branch: LANDBANK West Avenue Branch, euezon City
Note: indicate in the original deposit slip the BANK BRANCH where iansaction was
done.
* iS ENCIOSEd AS A ChECK(3[AYAbIE tO ttle NINONIL KIDNEY
AND TRANSPLANT INSTITUTE
Check No. Bank:
4' Please fill up and retum this form, the original Deposit slip, and your filled
out NRL-NKTI Hemarology NEeAS Registration Form to the
National Reference Laboratory for Hematology, National Kidney it Transplant Institute,
East Avenue, Diliman, euezon City. pLEAsE KEE*
COPIES FOR YOTIR RECORDS.
5, The Official Receipt will be delivered together with your EeAS Sample.
b. Personal checks WILL NOT BE ACCEPTED.
