Accugenix Portal Account | Charles River

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Request for an Accugenix^® Customer Portal Account

Contact Information

First Name

Last Name

Email

Phone Number

Does your site currently send samples to us for identification?

Yes

No

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.

Organization Information

Organization Name

Department

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Purchasing Department Billing Information

Name

Email

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Billing Language

Sample Submission

When do you anticipate that you will send samples?

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