Request a Quote

Quote Request Form

Complete this form and we'll send you a formal quote within one business day.

Organization Information

Organization Type *

Organization Name *

Department / Lab Name

Principal Investigator (PI)

VAT / Tax ID

This organization is tax exempt

Contact Information

First Name *

Last Name *

Email *

Your Role *

Phone Number

Shipping Address

Address Line 1 *

Address Line 2

City *

State *

State / Province

ZIP / Postal Code *

Country *

Use our own FedEx/UPS account for shipping

Shipping Account Number

Order Details

Select Product & Quantity *

20 µg vial

SKU: LYSN-20

5×20 µg (100 µg total)

SKU: LYSN-100

Custom / Bulk Order

Custom aliquot sizes and larger quantities

Total Quantity Needed (µg) *

Preferred Aliquot Size (µg)

Payment & Billing

Payment Method *

Grant / Account Number

PO Number

Accounts Payable Email

I have a PO document to upload Billing address same as shipping

PO Document

Click to upload or drag and drop

PDF, Word, or image (max 2MB)

Billing Address

Additional Information

Preferred Delivery

How did you hear about us?

Special Instructions or Questions

What happens next?

We'll review your request and prepare a formal quote
You'll receive the quote via email within one business day
Submit the quote to your purchasing department
Send us your PO and we'll ship your order

Quote Request Form

Questions?