Apply for a Wholesale Account

Wholesale Account Application

Complete the application below to open your wholesale account. Takes about three minutes.

Fields marked * are required. Everything we ask for is required by the pharmacy to open your account, so an incomplete application cannot be processed.

About You

Which best describes you?*

First Name*

Last Name*

Email Address*

Phone Number*

Your Business

Company / Practice Name*

Company Website (optional)

Company Phone*

State of Registration*

The state where your business is legally registered or incorporated. This can differ from your business address.

* Required: enter your NPI or your Resale Tax ID (EIN). At least one of the two. Enter both if you have both.

National Provider Identifier (NPI) (NPI or EIN)

Resale Tax ID (EIN) (NPI or EIN)

Business Address

Address Line 1*

Address Line 2 (optional)

City*

State / Province*

ZIP / Postal Code*

Country*

Consent is not a condition of purchase. Message & data rates may apply. Message frequency may vary. Reply STOP to opt out of messages at any time. Reply HELP for assistance. You must be 18 years of age or older to use this SMS service.

By submitting this form, you agree to our Privacy Policy and Terms of Service.

Application Received

Thank you for your interest in oral dissolving peptides. We will review your application and be in touch within 1-2 business days. Check your email and phone for updates on your wholesale account approval.

Get in Touch

Phone: (737) 379-0933
Email: support@cliniclaunchlab.com
Hours: Mon-Fri 9:00 AM - 5:00 PM CT

What Happens Next?

After you submit your application, our Clinic Launch Lab team at Elite DCS LLC reviews your information. Most accounts are approved within 1-2 business days.

Once approved, you will receive access to the full wholesale catalog and can place your first order immediately.