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*Please include all required fields. Also please include a brief description of the service you require including the equipment with manufacturer and model number, if possible, and our knowledgeable staff will follow up.

CONTACT INFO

Contact Name:

Company Name:

E-Mail Address:

Phone (Include extension):

Street Address:

City:

State:

Zip:

Cole-Parmer Account Number:

DEVICE INFO

Type of Device:

Manufacturer:

Model #:

Description:

Device S/N (if available):

Calibration Length:

Need it expedited? Check this box if you want 3 to 5 day expedited service. $214 per device.

Note: Expedited times are at an additional cost and begin when our lab technicians receive your item into our system not when the carrier delivers it to our facility. It may take 2 to 4 days for us to get it from the shipping area to our lab.