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In May 2006 CLINIQA obtained the highest level of ISO certification awarded to IVD companies.

The ISO 13485 is an International Standard for Quality Systems more rigorous than ISO 9001 and designed for medical device manufacturers.

Sales Work Order

CLINIQA Order Form

Contact Information

Contact Name

Company Name

Phone No.

Fax No.

P.O. No.

Bill To:

Shipment Information

Desire Ship Date

Please ship the completed order at my expense using my overninght carrier.

Carrier Name

Account Number

Please complete if different from the billing address.
Ship To:

Special Shipping Instruction (if Any)

Item No. 1

Catalog No.

Product Description

Quantity

Lot number if applicable

Unit Price

Notes for item #1

Item No. 2

Catalog No.

Product Description

Quantity

Lot number if applicable

Unit Price

Notes for item #2

Item No. 3

Catalog No.

Product Description

Quantity

Lot number if applicable

Unit Price

Notes for item #3

Item No. 4

Catalog No.

Product Description

Quantity

Lot number if applicable

Unit Price

Notes for item #4

Item No. 5

Catalog No.

Product Description

Quantity

Lot number if applicable

Unit Price

Notes for Item #5

Item No. 6

Catalog No.

Product Description

Quantity

Lot number if applicable

Unit Price

Notes for item #6

Item No. 7

Catalog No.

Product Description

Quantity

Lot number if applicable

Unit Price

Notes for item #7

For catalog number and product description

288 Distribution Street • San Marcos, California 92078 • Phone: 800-728-5205 • Fax: 760-571-5197