Order form for microbiological tests

Company name*
Name*
First Last
Email*
Your PO Number / Reference
Test(s) to perform
Test to perform*
Test description*
Validation required*
- Yes
- No
Required if initial validation is not performed at Micro-Serve Laboratory
Detection limit*
Required period*
Specify period*
Number of samples*
Pooled test*
We will pool your samples together and produce one result for all samples pooled together.
Number of samples per pooled test*
Method*
Sterilization method*
Initial verification dose (kGy)
Product description*

(To be included in final report)
Product reference*

(To be included in final report)
Product lot number*
Product lot number(s)*
(To be included in final report)
Product description*
Quantity*
Comment or special instructions
Do you want to ad another test?*
Your PO Number / Reference
Test to perform*
Test description*
Validation required*
- Yes
- No
Required if initial validation is not performed at Micro-Serve Laboratory
Detection limit*
Required period*
Specify period*
Number of samples*
Pooled test*
We will pool your samples together and produce one result for all samples pooled together.
Number of samples per pooled test*
Method*
Sterilization method*
Initial verification dose (kGy)
Product description*

(To be included in final report)
Product reference*

(To be included in final report)
Product lot number*
Product lot number(s)*
(To be included in final report)
Product description*
Quantity*
Comment or special instructions
Do you want to ad another test?*
Your PO Number / Reference
Test to perform*
Test description*
Validation required*
- Yes
- No
Required if initial validation is not performed at Micro-Serve Laboratory
Detection limit*
Required period*
Specify period*
Number of samples*
Pooled test*
We will pool your samples together and produce one result for all samples pooled together.
Number of samples per pooled test*
Method*
Sterilization method*
Initial verification dose (kGy)
Product description*

(To be included in final report)
Product reference*

(To be included in final report)
Product lot number*
Product lot number(s)*
(To be included in final report)
Product description*
Quantity*
Comment or special instructions

89511

Notes:
* After testing the products will be discharged
* By placing this order customer declares that he has received and agrees with the general terms and conditions of Micro-Serve Laboratory

+31 - (0)318 - 501 633

Test(s) to perform

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Terms & Conditions

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version: 21-11-2023
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