My Account

*Note: Membership to this portal is Private. Once your account information has been submitted, the portal Administrator will be notified and your application will be subjected to a screening procedure. If your application is authorized, you will receive notification of your access to the portal environment. All fields marked with an asterisk (*) are required.

First Name: Enter your First Name	*
Last Name: Enter your Last Name	*
User Name: Choose a User Name. If the user name already exists you will get an opportunity to select an alternate name.	*
Password: Choose a Password	*
Confirm: Re-Enter your Password to confirm the typing	*
Email Address: Enter your Email Address	*
Website: Enter your Website Address
Company Name Company Name

Street: Enter the Street part of your Address (eg 1 Main Street)	*Street Is Required.
Primary Account #: Enter the Primary Account #
City: Enter the City	*City Is Required.
Country: Enter the Country	*Country is Required.
State: Enter the Region	*Region Is Required.
Postal Code: Enter the Postal Code	*Postal Code Is Required.
Telephone: Enter Telephone No.	*Telephone Number Is Required.
Cell: Enter Cell Phone No.	*Cell Phone Number Is Required.
Fax: Enter Fax No.	Fax Number Is Required.

Preferences

Preferred Language: Select your preferred language from the available Locales
Time Zone: Select your Time Zone

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Laboratories

ServiTech Laboratories

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