Order Form | Nova-One Diagnostics

It’s easy to order from NOVA-ONE® by email or fax. If you do not have a PO system for the office, simply fax us a copy of your office letterhead stationery (so we have a legible address), stating which product you want to order and that you understand the price will include prepaid FedEx shipping costs.

If you prefer to fill the form in by hand, download the pdf version. order form

Telephone (818) 348-1543 • Fax (818) 348- 9696 • Email nova-one@nova-one.com
NOVA-ONE DIAGNOSTICS, 22287 Mulholland Hwy., Calabasas, CA 91302

Products

Liquid HbA1c Control 2 Vial Control Kit P/N NOD13111-100 L1 + L2 X 1mL = 2mL

Liquid HbA1c Control 4 Vial P/N NOD13122-100 2 x L1 + 2 x L2 X 1mL = 4mL

Liquid Diabetes Linearity/Verification 4 Vial P/N NOD HbL-G04041-100 L1 + L2 + L3 + L4 X 1mL = 4mL

Contact Information

Company Name*
Company Phone Number*

Contact Name*
Contact Phone Number*

Ship to Street Address, City, State, Zip*
(we will ship and bill you)
Bill to Address (if the same as shipping address, type in "same as shipping address")

Special Shipping Instructions
(i.e., leave with Receptionist)
Special Requirements (i.e. is your office closed at various times such that FedEx may not be able to deliver during a particular time?)

Email Address*
(NOD® does not share any customer information so your e-mail address is safe with us)Internal Purchase Order or Reference Number (if available)
If you do not have a PO system for the office, fax us a copy of your office letterhead stationery (so we have a legible address), stating which product you want to order and that you understand the price will include prepaid FedEx shipping costs.

Do you Want Us to Bill (Invoice) You OR
Do You Want to Pay With a Credit Card?Invoice would be sent after shipment, or if paying by credit card, please fill out the information below.

Credit Card Type MasterCard Visa

Cardholder Name
Credit Card Number

Expiration Date

IMPORTANT:   Customers are responsible for notifying NOD of any order requirements differing from those expressed and are encouraged to review current product claims and specifications prior to ordering. NOD does not perform a formal review of all orders and instead continually reviews relevant product information online or in advertising materials to confirm the most current information is available to our customers.

For international customers, our products may be purchased directly from NOVA-ONE DIAGNOSTICS® LLC
Please include the following information with all orders:

Name, telephone number, FAX number, shipping address, and billing address
Quantity, product name, and catalog number
Purchase order number
If paying by VISA/MasterCard: account number, expiration date, cardholder name,  and cardholder billing address
If purchasing Clinical Diagnostics: instrument that will be used.
Acknowledgement of our CONDITIONS OF SALE described below.

TERMS:
U.S. and Canada: Overdue amounts subject to a 1.5% late fee.
International Orders: Prepayment in full.

CONDITIONS OF SALE:
All products labeled “For Research Use” must be used for research use only in the U.S. and not for in vitro or diagnostic or clinical use. All products should be used in accordance with their labeled intended use.

NOVA-ONE DIAGNOSTICS LLC warrants that its products conform to the information contained in this and other NOVA-ONE DIAGNOSTICS LLC publications. Website information may not be up to date. Purchaser must determine suitability of the product for his/her particular use. THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. IN NO CASE SHALL NOVA-ONE DIAGNOSTICS LLC BE LIABLE FOR LOST PROFITS OR DIRECT, INDIRECT, INCIDENTAL, OR CONSEQUENTIAL DAMAGES INCURRED BY THE BUYER OR THIRD PARTIES. By accepting shipments from NOVA-ONE DIAGNOSTICS LLC, the buyer explicitly recognizes and agrees to these Conditions of Sale.