CRMLN Data Submission Form

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Overview

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

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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 cdclsp@cdc.gov

Lab ID

Pool Series

PS0720

mg/dL

Submission Date (please use calendar)

mmol/L

Unit of Measure (please use drop down)

mg/dL

Comment

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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

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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

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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

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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

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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

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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

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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
Comment