Tuttnauer is an Israeli company and all the sterilizers are made in their factories in Jerusalem. They are shipped all around the world. They also have the highest quality and meet or exceed all the US and European standards. They are built with safety in mind and are ASME stamped. They have UL approved components and are FDA approved. They all come with a one-year warranty on the sterilizer and a fifteen-year warranty on the chambers
Yes, they are a bit complicated so they will need an installation by a professional. And they will need electricity running between 220 volts and 480 volts. It will also need floor drains so that water can be evacuated after the cycle.