Request for an Accugenix® Customer Portal Account

Contact Information联系方式

First Name 名*

Last Name 姓*

Email 电子邮件地址*

Does your site currently send samples to us for identification?贵公司目前是否利用本公司做鉴定?*

Yes是

No否

Organization Information贵公司信息

Organization Name公司名称*

Department 部门*

Address 1地址1*

Address 2地址2

City/Town 城市/县*

Province 省*

Select

Postal Code邮证编码*

Country 国家*

Select

Purchasing Department Information 采购部门信息

Contact Name 姓名*

Address 1-地址1*

Address 2-地址2

City/Town-城市/县*

Province-省*

Select

Country国家*

Select

Language语言*

Yes, I would like to receive email communications from Charles River and allow for my information to be used for any follow-up requests to identify potential products or services relevant to my needs.*

我愿意接受Charles River Labs通过电子邮件发送测序鉴定介绍以及Charles River Labs其他服务的推送。

Send me a copy of my responses

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