Mycoplasma Testing / Sterility Testing Form

Mycoplasma Testing / Sterility Testing

	Name
	Job Title
	Company
	Address
	Postcode
	Country
	Telephone
	Fax
	Email
	Purchase Order Number
Mycoplasma Testing: Details of cell line to be submitted
	Cell Line Name
		Frozen Growing
	Details of medium for growth
	Tests required	PCR (ECACC in-house protocol) DNA Stain (ECACC in-house protocol) DNA Stain (US FDA approved protocol) Culture Isolation (ECACC in-house protocol) Culture Isolation (US FDA approved protocol)
	Passaged twice off antibiotics	Yes No
	Any other comments or information
Sterility Testing Details of cell line to be submitted
	Cell Line Name
		Frozen Growing
	Details of medium for growth
	Tests Required
	Any other comments or information