Fill - Bioneeds

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No.:
Date:
www.bioneeds.in
REQUEST FORM – BIOANALYTICAL ASSAY
(for Ligand binding assays, Quantification assays, Immunogenicity
Particulars
Details
Product Name
Manufacturer/supplier
( Mandatory : e mail ID and Phone
number )
Batch No.
Date of Manufacture
Date of Expiry
CoA of the product ( provide as
supplement)
Method of analysis
Yes
No
Method Development requirement
Yes
No
Supply of Critical reagents
( antibodies/ conjugates /others )
Validation guideline
(USFDA/EMA/others)
Yes
No
Availability of Method
Specify if any commercial kit to be
used
Number of samples for analysis
Additional information ( if any)
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Requested by:
Date:
Address for Correspondence : BIONEEDS, “Siddhi Siri Veera Sadana”, 6th Cross, Ashok Nagar,
Tumkur – 572 102, Karnataka, Mob: 09844457677, Phone: 0816-2243751-55, Fax: 0816-2243333
Address of facility : BIONEEDS, Devarahosahally, Sompura Hobali, Nelamangala Taluk,
Bangalore Rural District, Karnataka, INDIA, Email: [email protected]
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