Midland Scientific Sample Request Email Address of Midland Rep: Name of Midland Rep Requesting Sample: Customs PO: Customer's First Name: Customer's Last Name: Customer's Email Address: Customer's Company/Institution: Customer's Phone Number: Customer's Address: Customer's Address: Customer's Address: Customer's Address: City City State/Province State/Province Zip/Postal Zip/Postal Country AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCôte d'IvoireCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Sample Kit Requested: * D1097-00S E-Z 96 FastFilter Plasmid KitD1196-00S E-Z 96 Tissue DNA KitD1411-00S E-Z 96 Plant DNA DS KitD2411-00S E.Z.N.A. Plant DNA DS KitD2485-00S E.Z.N.A. HP Plant & Fungal DNA KitD2500-00S E.Z.N.A. Gel Extraction Kit (V-spin)D3350-00S E.Z.N.A. Bacterial DNA KitD3373-00S E.Z.N.A. Mollusc & Insect DNA KitD3396-00S E.Z.N.A. Tissue DNA KitD3399-00S E.Z.N.A. FFPE DNA KitD3485-00S E.Z.N.A. Plant & Fungal DNA KitD4015-00S E.Z.N.A. Stool DNA KitD4035-00S E.Z.N.A. Universal Pathogen KitD5525-00S E.Z.N.A. Water DNA KitD5625-00S E.Z.N.A. Soil DNA KitD6294-00S MicroElute Cycle-Pure & Gel Extraction KitD6492-00S E.Z.N.A. Cycle Pure Kit (V-spin)D6900-00S E.Z.N.A. M13 DNA Mini KitD6904-00S E.Z.N.A. Plasmid DNA Midi KitD6905-00S E.Z.N.A. FastFilter Plasmid DNA Midi KitD6915-00S E.Z.N.A. Endo-Free Plasmid DNA Midi KitD6922-00S E.Z.N.A. Plasmid DNA Maxi KitD6924-00S E.Z.N.A. FastFilter Plasmid DNA Maxi KitD6926-00S E.Z.N.A. Endo-Free Plasmid DNA Maxi KitD6942-00S E.Z.N.A. Plasmid DNA Mini Kit I, (Q - spin)D6943-00S E.Z.N.A. Plasmid DNA Mini Kit I, (V-spin)D6944-00S E.Z.N.A. FastFilter Plasmid DNA Mini KitD6945-00S E.Z.N.A. Plasmid DNA Mini Kit IID6950-00S E.Z.N.A. Endo-free Plasmid DNA Mini Kit IIM1128-00S Mag-Bind Plant DNA Plus 96 KitM1130-00S Mag-Bind Plant DNA DS 96 KitM1261-00S Mag-Bind Endo-free Plasmid Mini KitM1272-00S Mag-Bind Endo-free Plasmid Midi KitM1300-00S Mag-Bind SeqDTRM1378-00S Mag-Bind TotalPure NGSM2350-00S Mag-Bind Bacterial DNA 96 KitM2551-00S Mag-Bind FFPE RNA 96 KitM3292-00S Mag-Bind Blood DNA HV KitM3298-00S Mag-Bind cfDNA KitM4016-00S Mag-Bind Stool DNA 96 KitM4029-00S Mag-Bind Universal Pathogen 96 KitM5645-00S Mag-Bind Environmental DNA 96 KitM6399-00S Mag-Bind Blood & Tissue DNA HDQ 96 KitM6731-00S Mag-Bind Total RNA 96 KitM6932-00S Mag-Bind DNA/RNA KitM6955-00S Mag-Bind FFPE DNA/RNA 96 KitM7763-00S Mag-Bind PX Blood RNA 96 KitR1034-00S E-Z 96 Total RNA KitR6731-00S E.Z.N.A. DNA/RNA Isolation KitR6812-00S E.Z.N.A. HP Total RNA KitR6814-00S E.Z.N.A. Blood RNA KitR6827-00S E.Z.N.A. Plant RNA KitR6831-00S E.Z.N.A. MicroElute Total RNA KitR6834-00S E.Z.N.A. Total RNA Kit IR6934-00S E.Z.N.A.Total RNA Kit IIR6950-00S E.Z.N.A. Bacterial RNA KitR6954-00S E.Z.N.A. FFPE RNA KitR7034-00S E.Z.N.A. Micro RNA Kit Sample Kit Requested: D1097-00S E-Z 96 FastFilter Plasmid KitD1196-00S E-Z 96 Tissue DNA KitD1411-00S E-Z 96 Plant DNA DS KitD2411-00S E.Z.N.A. Plant DNA DS KitD2485-00S E.Z.N.A. HP Plant & Fungal DNA KitD2500-00S E.Z.N.A. Gel Extraction Kit (V-spin)D3350-00S E.Z.N.A. Bacterial DNA KitD3373-00S E.Z.N.A. Mollusc & Insect DNA KitD3396-00S E.Z.N.A. Tissue DNA KitD3399-00S E.Z.N.A. FFPE DNA KitD3485-00S E.Z.N.A. Plant & Fungal DNA KitD4015-00S E.Z.N.A. Stool DNA KitD4035-00S E.Z.N.A. Universal Pathogen KitD5525-00S E.Z.N.A. Water DNA KitD5625-00S E.Z.N.A. Soil DNA KitD6294-00S MicroElute Cycle-Pure & Gel Extraction KitD6492-00S E.Z.N.A. Cycle Pure Kit (V-spin)D6900-00S E.Z.N.A. M13 DNA Mini KitD6904-00S E.Z.N.A. Plasmid DNA Midi KitD6905-00S E.Z.N.A. FastFilter Plasmid DNA Midi KitD6915-00S E.Z.N.A. Endo-Free Plasmid DNA Midi KitD6922-00S E.Z.N.A. Plasmid DNA Maxi KitD6924-00S E.Z.N.A. FastFilter Plasmid DNA Maxi KitD6926-00S E.Z.N.A. Endo-Free Plasmid DNA Maxi KitD6942-00S E.Z.N.A. Plasmid DNA Mini Kit I, (Q - spin)D6943-00S E.Z.N.A. Plasmid DNA Mini Kit I, (V-spin)D6944-00S E.Z.N.A. FastFilter Plasmid DNA Mini KitD6945-00S E.Z.N.A. Plasmid DNA Mini Kit IID6950-00S E.Z.N.A. Endo-free Plasmid DNA Mini Kit IIM1128-00S Mag-Bind Plant DNA Plus 96 KitM1130-00S Mag-Bind Plant DNA DS 96 KitM1261-00S Mag-Bind Endo-free Plasmid Mini KitM1272-00S Mag-Bind Endo-free Plasmid Midi KitM1300-00S Mag-Bind SeqDTRM1378-00S Mag-Bind TotalPure NGSM2350-00S Mag-Bind Bacterial DNA 96 KitM2551-00S Mag-Bind FFPE RNA 96 KitM3292-00S Mag-Bind Blood DNA HV KitM3298-00S Mag-Bind cfDNA KitM4016-00S Mag-Bind Stool DNA 96 KitM4029-00S Mag-Bind Universal Pathogen 96 KitM5645-00S Mag-Bind Environmental DNA 96 KitM6399-00S Mag-Bind Blood & Tissue DNA HDQ 96 KitM6731-00S Mag-Bind Total RNA 96 KitM6932-00S Mag-Bind DNA/RNA KitM6955-00S Mag-Bind FFPE DNA/RNA 96 KitM7763-00S Mag-Bind PX Blood RNA 96 KitR1034-00S E-Z 96 Total RNA KitR6731-00S E.Z.N.A. DNA/RNA Isolation KitR6812-00S E.Z.N.A. HP Total RNA KitR6814-00S E.Z.N.A. Blood RNA KitR6827-00S E.Z.N.A. Plant RNA KitR6831-00S E.Z.N.A. MicroElute Total RNA KitR6834-00S E.Z.N.A. Total RNA Kit IR6934-00S E.Z.N.A.Total RNA Kit IIR6950-00S E.Z.N.A. Bacterial RNA KitR6954-00S E.Z.N.A. FFPE RNA KitR7034-00S E.Z.N.A. Micro RNA Kit Sample Kit Requested: D1097-00S E-Z 96 FastFilter Plasmid KitD1196-00S E-Z 96 Tissue DNA KitD1411-00S E-Z 96 Plant DNA DS KitD2411-00S E.Z.N.A. Plant DNA DS KitD2485-00S E.Z.N.A. HP Plant & Fungal DNA KitD2500-00S E.Z.N.A. Gel Extraction Kit (V-spin)D3350-00S E.Z.N.A. Bacterial DNA KitD3373-00S E.Z.N.A. Mollusc & Insect DNA KitD3396-00S E.Z.N.A. Tissue DNA KitD3399-00S E.Z.N.A. FFPE DNA KitD3485-00S E.Z.N.A. Plant & Fungal DNA KitD4015-00S E.Z.N.A. Stool DNA KitD4035-00S E.Z.N.A. Universal Pathogen KitD5525-00S E.Z.N.A. Water DNA KitD5625-00S E.Z.N.A. Soil DNA KitD6294-00S MicroElute Cycle-Pure & Gel Extraction KitD6492-00S E.Z.N.A. Cycle Pure Kit (V-spin)D6900-00S E.Z.N.A. M13 DNA Mini KitD6904-00S E.Z.N.A. Plasmid DNA Midi KitD6905-00S E.Z.N.A. FastFilter Plasmid DNA Midi KitD6915-00S E.Z.N.A. Endo-Free Plasmid DNA Midi KitD6922-00S E.Z.N.A. Plasmid DNA Maxi KitD6924-00S E.Z.N.A. FastFilter Plasmid DNA Maxi KitD6926-00S E.Z.N.A. Endo-Free Plasmid DNA Maxi KitD6942-00S E.Z.N.A. Plasmid DNA Mini Kit I, (Q - spin)D6943-00S E.Z.N.A. Plasmid DNA Mini Kit I, (V-spin)D6944-00S E.Z.N.A. FastFilter Plasmid DNA Mini KitD6945-00S E.Z.N.A. Plasmid DNA Mini Kit IID6950-00S E.Z.N.A. Endo-free Plasmid DNA Mini Kit IIM1128-00S Mag-Bind Plant DNA Plus 96 KitM1130-00S Mag-Bind Plant DNA DS 96 KitM1261-00S Mag-Bind Endo-free Plasmid Mini KitM1272-00S Mag-Bind Endo-free Plasmid Midi KitM1300-00S Mag-Bind SeqDTRM1378-00S Mag-Bind TotalPure NGSM2350-00S Mag-Bind Bacterial DNA 96 KitM2551-00S Mag-Bind FFPE RNA 96 KitM3292-00S Mag-Bind Blood DNA HV KitM3298-00S Mag-Bind cfDNA KitM4016-00S Mag-Bind Stool DNA 96 KitM4029-00S Mag-Bind Universal Pathogen 96 KitM5645-00S Mag-Bind Environmental DNA 96 KitM6399-00S Mag-Bind Blood & Tissue DNA HDQ 96 KitM6731-00S Mag-Bind Total RNA 96 KitM6932-00S Mag-Bind DNA/RNA KitM6955-00S Mag-Bind FFPE DNA/RNA 96 KitM7763-00S Mag-Bind PX Blood RNA 96 KitR1034-00S E-Z 96 Total RNA KitR6731-00S E.Z.N.A. DNA/RNA Isolation KitR6812-00S E.Z.N.A. HP Total RNA KitR6814-00S E.Z.N.A. Blood RNA KitR6827-00S E.Z.N.A. Plant RNA KitR6831-00S E.Z.N.A. MicroElute Total RNA KitR6834-00S E.Z.N.A. Total RNA Kit IR6934-00S E.Z.N.A.Total RNA Kit IIR6950-00S E.Z.N.A. Bacterial RNA KitR6954-00S E.Z.N.A. FFPE RNA KitR7034-00S E.Z.N.A. Micro RNA Kit Downstream applications NGS, qPCR Sample Type Serum, blood, bacterial cultures etc.., Comments/Notes: Competitor information etc.., Captcha Submit If you are human, leave this field blank. Δ
