Multiplexion - Cell Line Contamination Test Form

Contamination test - Service information

Service type

Contamination test - Sample information

Number of samples for contamination testing

Additional Information

Please enter any additional information or promo-codes here.

Cell contamination test - Billing information

Courtesy Title

Given name

Surname

Company / Institution

Department

Cost Unit

Address

Postal code

City

Country

Email

Telephone

Fax

If applicable:

V.A.T. ID

Order Information

Date of Ordering (DD/MM/YYYY)

Purchase order number

Terms and Conditions & Data protection

Terms and Conditions I accept the Terms & Conditions

EU GDPR/DSGVO compliance I hereby agree to Multiplexion GmbH to store and use my submitted information

Dear customer, many thanks for your order!

A confirmation Email will be sent to you automatically.

IMPORTANT:

- Please make sure that your samples are prepared according to the lysate protocol

- Label sample tubes with the specific sample name as provided in the submission form.

- Please ship your samples AND a copy of the confirmation Email to:

Multiplexion GmbH

c/o DKFZ

D320, Im Neuenheimer Feld 280

D-69120 Heidelberg

Germany