Become a Client
Client Information Form

To learn more about our services or to set up a new account, please call 800.227.5227(LABS) or complete the form below.

Provider Details

Please enter your first name.

Please enter you last name.

Please enter your credentials.

Individual Type 1

Please enter the name of your company.

Please enter your specialty type here.

Please enter your phone number.

Please enter in your fax number

Please choose your preferred method of contact.

Business Address

Kits and requested materials will be sent to this address. 

Please use this field to add any extra address information.

Please enter in the name of your city.

Please choose a state from the selection menu.

Please enter in your five digit zip code.

Need Help Today?
Let us know how we can assist you immediately.

I would like more information on:

Please choose which items you would like to receive more information on.

Please let us know how you found out about SpectraCell.

Privacy Policy:

SpectraCell respects the privacy of any and all information processed through our website. Under no circumstances will SpectraCell sell, transfer or disseminate your personal information gathered via our website to any other entity. If you have questions or concerns regarding our privacy policies, please fully read our Privacy Policy via our website or contact