Ordering Information

* indicates required fields

For orders within the US please provide the following information:
(for orders outside the US please inquire by email)

Orders may be placed by phone, fax or e-mail:
Phone:    858.775.1278
Fax:        760.789.8929
E-mail:     orders@proteus-biosciences.com

Contact Information

Name * Phone * Fax * Email Address *

Invoice Address

Purchasing Agent Name * Phone Number * Institution Name * Attention * Address * City * State * Zip Code *

Shipping Address

Institution Name * End User Name * Phone Number * Attention Address * City * State * Zip Code *

Payment Information

Purchase Order Number *

If you would like to pay by credit card, for security purposes, we will contact you by phone for the information.

Product Information

Catalog #	Quantity