Custom Product

Please provide as much information as available describing your custom product using this online form. We will contact you shortly, once we receive your request.


Company:

      
           
  Company Name:   Title:
  Contact Name:   Date: November 4, 2009
  Phone:   Email:
           

1. Product Application
  In process validation Proficiency Performance External Control
  QC Release Sensitivity Training    
  Calibration Specificity Interfering Substances    
  Instrument Validation Linearity Internal Control (IC)    
  Other  
  Software:    
  Proficiency Software (LabQC.net)
  Laboratory Proficiency Program (EDC Net)
     
Brief description for use of Panel/Control:
   

2. Analyte Specifications:

    
  Inactivation: Yes No    
 

Virus:

Concentration:

Unit of Measure:

Volume:

# of Vials
   
   
   
   
   
   
   
   
   
   
             

3. Sample Matrices
  EDTA Plasma Stool (Synthetic)
  Commutable EDTA Plasma Bacterial Stabilizing Matrix
  Serum Urine (Synthetic)
  CSF (Synthetic) Other
         

4. Packaging
 
   

5. Labeling:
 
   

6. Vials
 
   

7. Release Testing Requirements:
 
   

8. Certificate of Analysis Content:
 
   

9. Finished Material Disposition:
  Storage: 2 - 8°C -20°C -70°C
       

10. Shipping:
    Ambient Gel Pack Dry Ice
    Direct Drop ship to other    
               
  Send copy to myself