849 International Drive, 4th Floor, Linthicum, MD, 21090, US
Please Provide Your Business Name(s)
Is the lab 17025 ISO/IEC accredited?
Please upload a copy of the certificate of accreditation, the scope of accreditation, and all supporting documentation.
IS YOUR PHYSICAL ADDRESS THE SAME AS YOUR MAILING ADDRESS?
Additional Point-of-Contact (if applicable)
What type of business structure do you have?
Date of Incorporation/Formation
Has the business, a parent company, or any other intermediary business entity ever applied for a cannabis license or registration in any state or country? (regardless of whether or not the license or registration was ever issued)
Was the business, a parent company, or any other intermediary business entity who owned a cannabis license or registration, ever subject to any of the following actions?
Please provide a completed copy of Appendix A: Independent Testing Laboratory (Available for download on our website.) as well as a curriculum vitae (CV) for each employees listed in this application.
Check "Yes" and use the blank box to acknowledge that the lab is independent from all growers, processors, and dispensaries registered with the State of Maryland.
Signature of Authorized Representative