Mercedes Medical

Projected Lab Start Up Date * MM / DD / YYYY
Name * First Last
Business Name *
Business Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number * ### - ### - ####
Email *
Lab Equipment
LC/MS Fume Hoods Chemistry Screening Equipment Safety Cabinets
Other Lab Equipment Needs/Brand Preference?
Confirmation Lab Consumables
LC/MS Solvents Biohazard Bags Kim Wipes Chemistry Reagents Specimen Cups Spill Response Kit Controls/Calibrators DOA Cups Digital Thermometers Glassware Centrifuge Tubes Wash Bottles Tube Racks Pipettors Fire Blanket Well Plates Gloves
Other Consumables
Time Frame
Immediately Within A Year Long Term Goal
Do Not Fill This Out