MHEC D25 Laboratory Procurement Account Registration

Request access to Steri-Tech’s institutional purchasing portal for approved healthcare, government, educational, and commercial organizations.

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Company Name

Interest Business Email

Contact Name *

First

Last

Business Address

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Business Email *

Phone Number

Organization Type *— Select Choice —HospitalMedical ClinicGovernment AgencyEducational InstitutionLaboratoryDental PracticeCommercial BusinessNon-Profit Organization

Tax Exempt / Resale Certificate Number

If applicable, provide your organization’s tax exempt or resale certificate number.

Additional Procurement Notes:

Steri-Tech may request supporting tax exemption or resale documentation during account verification.

Purchasing Interest *— Select Choice —Medical SuppliesSterile Processing SuppliesLaboratory SuppliesPPEIndustrial SuppliesEducational SuppliesBulk ProcurementGovernment Contract Purchasing

Purchasing Volume

Submit